Figure 2.

Metabolically healthy obesity is a transient phenotype. Case example for a 48-year-old man undergoing different weight-loss interventions. At baseline, the patient presented with MUO as defined by reference (31). After 12 months of a behavior intervention program (calorie restricted diet, increased physical activity, and psychosocial support), the phenotype changed into MHO. Because treatment was not continued for the subsequent 12 months, there was a weight regain associated with a phenotype transition to MUO. At 24 months, the patient underwent a laparoscopic Roux-en-Y gastric bypass surgery, which resulted in significant weight loss and improvements in all criteria defining MHO. The case demonstrates that transitions between MUO and MHO are not unidirectional and may change over time, for instance in response to weight-loss interventions. Abbreviations: BMI, body mass index; BP, blood pressure; FPG, fasting plasma glucose; HDL-C, high-density lipoprotein cholesterol; TG, triglycerides.