The thin fat paradox: Understanding normal weight obesity and its clinical relevance

Winda Angriani 1, Aisyah Elliyanti 2 and Desmawati Desmawati 3, *

1 Master Program in Biomedical Sciences, Faculty of Medicine, Universitas Andalas, Padang, West Sumatera, Indonesia,   25127.
2 Nuclear Medicine Divisional, Department of Radiology, Faculty of Medicine, Universitas Andalas / Nuclear Medicine and department of Radiology Nuclear Medicine Division Dr. M. Djamil Hospital, Padang, West Sumatera, Indonesia, 25127.
3 Department of Nutrition, Faculty of Medicine, Universitas Andalas, Padang, West Sumatera, Indonesia, 25127.
 
Research Article
World Journal of Advanced Research and Reviews, 2024, 22(02), 354–362
Article DOI: 10.30574/wjarr.2024.22.2.1400
 
Publication history: 
Received on 25 March 2024; revised on 04 May 2024; accepted on 06 May 2024
 
Abstract: 
Obesity, defined by the World Health Organization (WHO) as an excess accumulation of body fat or body fat percentage (BFP) associated with clear health risks, presents a significant global challenge. While Body Mass Index (BMI) serves as a conventional metric for identifying obesity, it fails to account for body composition variations, such as distinguishing between fat-free mass and adipose tissue. Consequently, individuals with normal BMI may exhibit excessive body fat (BFP≥30%), termed Normal Weight Obesity (NWO). In contrast, others with normal BMI and normal body fat are termed Normal Weight Lean (NWL).
NWO significantly elevates the risks of various metabolic disorders, including hyperglycemia, diabetes, hypertension, dyslipidemia, and reduced HDL levels. Moreover, NWO is associated with an increased risk of cardiovascular diseases (CVD), hypertension, low HDL, central obesity, and muscle weakness. Individuals with NWO face a heightened risk of developing cardiometabolic diseases, including atherosclerosis, coronary artery disease, stroke, and heart failure, due to the adverse effects of excess body fat on cardiovascular health. Furthermore, NWO is associated with insulin resistance, inflammation, and endothelial dysfunction, further exacerbating the risk of metabolic disorders and cardiovascular complications.
Early identification of NWO is crucial for implementing preventive measures and lifestyle interventions to mitigate these health risks. Integrating body fat percentage measurements into nutritional screening protocols in healthcare facilities is essential for identifying individuals at risk of NWO and initiating appropriate interventions to prevent the onset of cardiometabolic diseases. This study aims to provide comprehensive insights into Normal-Weight Obesity (NWO) and its potential health implications.
 
Keywords: 
Body Fat Percentage; Cardiovascular Risk; Metabolic Disorders; Normal Weight Obesity 
 
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