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Resumen

Obesity has become a major health problem in the 21st century, affecting millions of people around the world. It is assumed that obesity is accompanied by different comorbidities that are related to a reduction in life expectancy. However, this situation has not been seen in all people with obesity, since it has been observed that some obese people show protection against cardiometabolic disorders related to obesity, a condition known as metabolically healthy obesity (MHO). At present, the definition of MHO varies according to the bibliographic source used, so it is not very precise. Furthermore, in the absence of universal criteria for identification of MHO, prevalence data vary between investigations. Some physiological, functional and pathological differences have been identified between MHO and metabolically unhealthy obesity (MUO): individuals with MHU, for example, retain insulin sensitivity and do not suffer from hypertension or dyslipidemia compared to MUO. In addition, people with MHO are protected against type 2 diabetes, cardiovascular disease and other causes of death. Some responsible for these differences are the accumulation of visceral fat and the dysfunction of the adipose tissue. Consequently, despite the fact that the body mass index is directly related to the severity of the complications derived from obesity-related comorbidities, it can be stated that fat location and adipose tissue dysfunction are even more directly related.