Cardiometabolic Outcomes Among Adults With Abdominal Obesity and Normal Body Mass Index

Ahmed, KY; Aychiluhm, SB; Thapa, S; Tegegne, TK; Ketema, DB; Kassa, ZY; Kibret, GD; Duko, B; Shifti, DM; Bore, MG; Nezenega, ZS; Bedaso, A; Hailegebireal, AH; Bizuayehu, HM; Dadi, AF; Beyene, T; Shaikh, MF; Hassen, TA; Seid, A; Astawesegn, FH; Belachew, SA; Leshargie, CT; Berhe, FT; Mondal, UK; Little, D; Hewa Marambage, KA; Mahmood, S; Ross, AG

doi:10.1001/jamanetworkopen.2025.37942

Obesity

Cardiometabolic Outcomes Among Adults With Abdominal Obesity and Normal Body Mass Index

JAMA Netw OpenPublished 1 Oct 2025Cross-sectional study

Read the original article ↗PubMed

Cite

Authors' conclusion

In this cross-sectional study, more than 1 in 5 adults worldwide with a normal BMI had abdominal obesity. Relying solely on BMI may be insufficient to identify these high-risk individuals and provide timely interventions. The findings have implications for the United Nations' Sustainable Development Goal targets 2.2 (ending all forms of malnutrition) and 3.4 (reducing premature mortality from noncommunicable diseases).

Study context

Population: Adults aged 15 to 69 years or 18 to 69 years (per national definitions) in WHO STEPS surveys from 91 countries; mean (SD) age 40.4 (15.9) years; 57.8% female
Participants: 471,228 adults

Exposure: Normal-weight abdominal obesity vs normal body mass index (BMI) without abdominal obesity
Outcome: Hypertension, diabetes, cholesterol and triglycerides

Methodological detailsWHO STEPS survey datasets 2000–2020, 91 countries, multivariable binary logistic regression, Data analysed between April 2024 and January 2025

WHO STEPS survey datasets 2000–2020
91 countries
Multivariable binary logistic regression
Data analysed between April 2024 and January 2025

Main finding

As reported in the abstract

Association of normal BMI with abdominal obesity with cardiometabolic outcomes

Hypertension, OR

1.29 (1.25-1.33) (95% CI)

Diabetes, OR

1.81 (1.72-1.90) (95% CI)

High total cholesterol, OR

1.39 (1.35-1.44) (95% CI)

High TG, OR

1.56 (1.48-1.64) (95% CI)

Observational data: associations, not effects.

Further findings

Global prevalence of abdominal obesity among participants with normal BMI

Global, %: 21.7% (21.5%-21.8%) (95% CI)
Western Pacific region (lowest region), %: 15.3% (15.0%-15.7%) (95% CI)
Eastern Mediterranean region (highest region), %: 32.6% (31.9%-33.3%) (95% CI)
Lebanon (highest), %: 58.4% (54.1%-62.6%) (95% CI)
Mozambique (lowest), %: 6.9% (5.9%-8.1%) (95% CI)

Factors associated with abdominal obesity

Primary education, OR: 1.53 (1.50-1.57) (95% CI)
Secondary or higher education, OR: 2.38 (2.33-2.43) (95% CI)
Unemployment, OR: 1.25 (1.23-1.27) (95% CI)
Low fruits and vegetables intake, OR: 1.22 (1.20-1.24) (95% CI)
Physical inactivity, OR: 1.60 (1.57-1.63) (95% CI)

Original publication

Cardiometabolic Outcomes Among Adults With Abdominal Obesity and Normal Body Mass Index. JAMA Netw Open. Published 1 October 2025. doi:10.1001/jamanetworkopen.2025.37942

Read the original article ↗

Composed by AI from the published abstract and checked against it. How Briefs are made →