Metabolically Healthy Obesity (MHO)—New Research Directions for Personalised Medicine in Cardiovascular Prevention

PURPOSE OF REVIEW: To discuss new findings on the heterogeneity of obesity and associated risks. RECENT FINDINGS: Obesity is a public health problem of immense importance on a global scale. However, epidemiological findings and clinical studies have revealed that obesity is a heterogeneous phenotype and that not all obese subjects run the same risk for complications. Current research has tried to describe so-called metabolically healthy obesity (MHO), defined by lack of risk factors included in the metabolic syndrome. These subjects will not escape long-term complications, but mortality risk is not increased. However, a new definition of MHO has recently been proposed, based on the lack of hospitalisation for somatic disease for decades in middle life. MHO subjects defined in this way are characterised by being “fat and fit” and also run a lower risk of long-term complications. SUMMARY: If MHO could be better understood, this could contribute to a more diverse clinical approach to obesity based on personalised medicine.