Is Metabolically Healthy Overweight or Obesity a Myth?

For years, people have debated whether high body-mass index (BMI) is itself an independent risk factor for adverse cardiovascular outcomes or whether such adverse outcomes are mediated by metabolic abnormalities that often accompany high BMI. In other words, are metabolically healthy overweight (BMI, 25–30 kg/m²) or obese (BMI, ≥30 kg/m²) people at greater risk for adverse outcomes than normal-weight people (BMI, 18–25 kg/m²)? To address this question, researchers performed a systematic review and meta-analysis of 12 observational studies (67,127 participants) in which metabolic status and cardiovascular outcomes were reported. Study participants were classified as metabolically unhealthy if they exhibited components of the metabolic syndro…