Prevalence and Predictors of Metabolically Healthy Obesity in Adolescents

Background: A subset of individuals with obesity display a normal cardiometabolic profile, termed metabolically healthy obesity (MHO). Objectives: To examine the prevalence and predictors of MHO in adolescents. Methods: Participants included 316 males and 316 females aged 12-19-years with a BMI ≥95th percentile from the 1999-2010 National Health and Nutrition Examination Surveys. First, MHO was defined as being free of type 2 diabetes, hypertension, and dyslipidemia and having <2 metabolic syndrome criteria. Second, MHO was defined as being free of all metabolic syndrome criteria, insulin resistance, and inflammation. Results: The prevalence of MHO varied from 7-74% depending on the definition. Lower obesity and lower insulin-resistance predicted MHO in males and females (p<0.01). Associations between dietary components and MHO were weak and inconsistent. Physical activity and inflammation were not associated with MHO (p>0.05). Conclusions: An emphasis on managing weight and insulin-resistance responses should be a central goal for adolescents with obesity.