Anti-obesity day 2025: Fit but overweight? Discover what metabolically healthy obesity really means

Obesity in India has risen sharply over the last two decades. The National Family Health Survey (NFHS-5, 2019–21) shows that almost one in four adults are obese, with rates ranging from 8% to 50% across different states. Both adults and children are now twice as likely to be overweight compared to fifteen years ago, and three times more than thirty years ago.

According to a nationwide study by the Indian Council of Medical Research (The Lancet Diabetes & Endocrinology, 2023) around one in three adults over twenty has abdominal obesity. Dr Ashish Gautam, Senior Director & Head of Bariatric & Laparoscopic Surgery, Max Super Speciality Hospital, Saket, New Delhi, says, “Urban lifestyles, lack of physical activity, and easy access to high-fat, sugary, and processed foods all play a role. As per the World Health Organisation (WHO), half of Indian adults do not get enough exercise.” He adds that poor diets, calorie-rich snacks, and limited activity explain most cases. "Obese children face higher chances of developing type 2 diabetes, high blood pressure, and heart problems as adults, as well as low self-esteem and depression", he says. The COVID-19 lockdowns, Dr Gautam tells Moneycontrol, worsened the situation, reducing movement and access to fresh foods.

Also Read: Obesity and diabetes: Here's how being overweight or obese causes Type 2 diabetes

Metabolically healthy obesity

We often assume obesity automatically means poor health. "Extra fat usually increases the risk of insulin resistance, high cholesterol, high blood pressure, and heart disease. But where the fat is stored matters. People carrying fat on their hips and thighs are often at lower risk than those with abdominal fat", says Dr Gautam.  Some obese people maintain normal blood pressure, cholesterol, and insulin levels. This is called Metabolically Healthy Obesity (MHO). However, MHO is not permanent—age, lifestyle, and genes can change your metabolic health. Regular check-ups remain essential.

Beyond BMI

BMI alone is not enough. Dr Gautam says, “Two people with the same BMI can have very different health risks depending on fat distribution, muscle, and metabolism.” He explains, “Abdominal fat is most harmful. Waist measurements and scans offer a clearer picture. Testing blood sugar, cholesterol, blood pressure, and insulin helps doctors identify MHO and focus on keeping metabolism healthy rather than only reducing weight.”

Managing metabolically healthy obesity

Healthy habits are important. “Eat better, reduce sugar and fat, and stay active. If this is not enough, bariatric surgery, like sleeve gastrectomy or gastric bypass, can help, especially for BMI above 32 with diabetes or hypertension, or BMI over 35.” Dr Gautam suggests. " Robotic surgery is precise, causes fewer complications, and helps recovery. Studies show lasting weight loss, better blood sugar, and fewer medications", he adds.

Also Read: Obesity treatments could change after THIS new discovery about fat-cell metabolism

Even with MHO, regular check-ups and healthy habits are vital. “Monitoring waist size, blood sugar, cholesterol, and blood pressure can prevent diabetes, heart disease, and other risks,” he concludes.

FAQs on Metabolically Healthy Obesity:

1. What is Metabolically Healthy Obesity (MHO)?

MHO refers to a condition where an individual is obese but maintains normal metabolic health, including normal blood pressure, cholesterol, and insulin levels.

2. Can MHO change over time?

Yes, MHO is not permanent. Age, lifestyle, and genetic factors can influence your metabolic health, making regular check-ups important.

3. Does fat distribution affect health risks?

Yes, where fat is stored matters. Abdominal fat is more harmful compared to fat stored on hips and thighs.

4. Why is regular monitoring important for individuals with MHO?

Regular monitoring of waist size, blood sugar, cholesterol, and blood pressure helps prevent diabetes, heart disease, and other risks.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.