The criteria of the identification of metabolic obesity among people with normal body weight and their use in everyday practice


  • Katarzyna Pastusiak
  • Juliusz Przysławski



metabolically obese normal weight, metabolic syndrome, diagnostic criteria


Obesity and the metabolic syndrome caused by it constitute one of the biggest health issues of the 21st century. However, a problem of “a concealed form of obesity” — metabolic obesity with a normal body weight, which manifests clinically through the occurrence of metabolism disorders related to obesity among people with a normal body mass index — was pointed out in the 1980s. This affliction entails similar health consequences and causes many more problems in diagnosis and early treatment because a lack of obesity does not make doctors search for the traits of metabolic syndrome among seemingly healthy patients. The aim of this study is to present a proposition of diagnostic criteria for this disease in the historical perspective and to consider the possibilities of their use in everyday clinic practice.


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Tomiyama AJ, Hunger JM, Nguyen-Cuu J, Wells C. Misclassification of cardiometabolic health when using body mass index categories in NHANES 2005–2012. Int J Obes (Lond). 2016 May;40(5):883–886.

Ruderman NB, Chrisholm D, Pi-Syner X, Schneider S. The metabolic obese, normal weight individual- revisited. Diabetes. 1998 May;47(5):699–713.

Dvorak RV, De Nino WF, Adas PA, Poehlman ET. Phenotipic charakteristic associated with insulin resistance in metabolically obese but normal weight young women. Diabetes. 1999 Nov;48(11):2210–2214.

Bucyk B, Tupikowska M, Bednarek-Tupikowska G. Kryteria rozpoznania zespołu metabolicznego z prawidłową masa ciała (MONW). Endokrynol Otyłość. 2009 Dec;5(4):226–232.

Molero-Conejo E, Morales LM, Fernandez V, Raleigh X, Gómez ME, Semprún-Fereira M, et. al. Lean adolescents with increased risk for metabolic syndrome. Arch Latinoam Nutr. 2003 Mar;53(1):39–46.

Goodpaster BH, Krishnaswami S, Resnick H, Kelley DE, Haggerty C, Harris TB, et. al. Association between region al adipose tissue distribution and both type 2 diabetes and impaired glucose tolerance in elderly man and women. Diabetes Care. 2003 Feb;26(2):372–379.

Conus F, Allison DB, Raabasa-Lhoret R, St-Onge M, St-Pierre DH, Tremblay-Lebeau A, et. al. Metabolic and behavioral charactreristics od metabolically obese but normal-weight women. J Clin Endocrinol Metab. 2004 Oct;89(10):5013–5020.

Succurro, Marini MA, Frontoni S, Hribal ML, Andreozzi F, Lauro R, Insulin Secretion in Metabolically Obese, but Normal Weight, and Metabolically Healthy but Obese Individuals. Obesity. 2008 Aug;16(8):1881–1886.

Katsuki A, Sumida Y, Urakawa H, Gabazza EC, Murashima S, Maruyama N, et. al. Increased visceral fat and serum levels of triglyceride are associated with insulin resistance in Japanese metabolically obese, normal-weight subjects with normal glucose tolerance. Diabetes Care. 2003 Aug;26(8):2341–4234.

Katsuki A, Sumida Y, Urakawa H, Gabazza EC, Murashima S, Matsumoto K, et. al. Plasma levels of adiponectin are associated with insulin resistance and serum levels of triglyceride in Japanese metabolically obese, normal-weight man with normal glucose tolerance. Diabetes Care. 2003 Oct;26(10):2964–2965.

Katsuki A, Sumida Y, Urakawa H, Gabazza EC, Murashima S, Nakatani K, Increased oxidative stress is associated with serum levels od triglyceride, insulin resistance and hiperinsulinemia in Japanese metabolically obese, normal-weight man. Diabetes Care. 2004 Feb;27(2):631–632.

De Lorenzo A, Nartinoli R, Vaia F, Di Renzo L. Normal weight obese (NWO) women: an evaluation of candidate new syndrome. Nutr Metab Cardiovasc Dis. 2006 Dec;16(8):513–523.

Romero-Corral A, Somers VK, Sierra-Johnson J, Korenfeld Y, Boarin S, Korinek J, Normal weight obesity: a risk factor for cardiometabolic disregulation and cardiovascular mortality. Eur Heart J. 2010 Mar;31(6):737–746.

She JL, King MTC., Yi Y, Gulliver W, Sun G. Body fat percentage is associated with cardiometabolic dysregulation in BMI-defined normal weight subjects. Nutr Metabol Cardiovasc Dis. 2012 Sep;22(9):741–747.

Wildman RP, Muntner P, Reynolds K, McGinn AP, Rajpathak S, Wylie-Rosett J, et. al. The Obese Without Cardiometabolic Risk Factor Clustering and the Normal Weight With Cardiometabolic Risk Factor ClusteringPrevalence and Correlates of 2 Phenotypes Among the US Population (NHANES 1999–2004). Arch Inter Med. 2008 Aug 11;168(15):1617–1624.

Kim JY, Han SH., Yang BM.: Implication of High-Body-Fat Percentage on Cardiometabolic Risk in Middle-Aged Healthy, Normal-Weight Adults. Obesity. 2013 Aug;21(8):1571–1577.

Marques-Vidal P, Pécoudo A, Hayoz D, Paccaud F, Mooser V, Waeber G, et. al. Prevelence of normal Wight obesity in Switzerland: effect of various definitions. Eur J Nutr. 2008 Aug;47(5):251–257.

Madeira FB, Silva AA, Veloso HF, Goldani MZ, Kac G, Cardoso VC, et. al. Normal Weight Obesity Is Associated with Metabolic Syndrome and Insulin Resistance in Young Adults from a Middle-Income Country. Plos One. 2013;8(3):e60673. doi: 10.1371/journal.pone.0060673. Epub 2013 Mar 28.

NCEP/ATP III. Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). Final report. Circulation. 2002 Dec 17;106(25):3143–3421.

St. Onge MP, Janssen I, Heynsfield SB. Metabolic syndrome in normal weight Americans. New definitions of metabolically obese, normal weight individuals. Diabetes Care. 2004 Sep;27(9):2222–2228.

Alberti K, Eckel, Groundy S, Zimmet PZ, Cleeman JI, Donato KA, et. al. Harmonizng the Metabolic Syndrome. A Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung and Blood Institiute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association of the Study of Obesity. Circulation. 2009 Oct 20;120(16):1640–1645.

Choi J, Se-Young O, Lee D, Tak S, Hong M, Park SM, et. al Characteristics of diet patterns in metabolically obese, normal weight adults (Korean national Health and Nutrition Examination III, 2005). Nutr Metab Cardiovasc Dis. 2012 Jul;22(7):567–574.

Galić BS, Pavlica T, Udicki M, Stokić E, Mikalački M, Korovljev D, et. al. Somatotype characteristics of normal-weight and obese women among different metabolic subtype. Arch Endocrinol Metab. 2016 Feb;60(1):60–65.

Kim JW, Kim DH, Roh YK, Ju SY, Nam HY, Nam GE, et. al. Serum Ferritin Levels Are Positively Associated With Metabolicall Obese Normal Weight A Nationwide Population-Based Study. 2015 Dec;94(52):e2335. doi: 10.1097/MD.0000000000002335.

Lee SH, Han K, Yang HK, Kim HS, Cho JH, Kwon HS, et. al. A novel criterion for identyfying metabolically obese but normal weight individuals using the product of triglicerides and glucose. Nutr Diabetes. 2015 Apr 27;5:e149. doi: 10.1038/nutd.2014.46.




How to Cite

Pastusiak K, Przysławski J. The criteria of the identification of metabolic obesity among people with normal body weight and their use in everyday practice. JMS [Internet]. 2018 Mar. 30 [cited 2024 Jun. 16];87(1):34-9. Available from:



Review Papers
Received 2017-10-30
Accepted 2018-06-21
Published 2018-03-30