Obesity

Differences in fat distribution between metabolically unhealthy people with normal weight versus obesity, NHANES 2011–2018

BMJ Open Diabetes Res CarePublished Cross-sectional study

Authors' conclusion

The study shows increased android fat as the main abnormality in MUL individuals and decreased gynoid fat as the main abnormality in MUO individuals. The differences in android and gynoid fat patterns between MUL and MUO groups suggest different mechanisms of metabolic dysfunction in people who are lean versus those with obesity.

Study context

Population
Adults in NHANES 2011–2018 with DXA; metabolic dysfunction = ≥2 metabolic syndrome components, excluding obesity
Exposure
Metabolically unhealthy vs metabolically healthy individuals, with normal weight and with obesity
Outcome
Body fat distribution (DXA) in metabolically unhealthy vs healthy individuals
Methodological detailsNHANES 2011-2018, DXA, interaction term analysis
  • NHANES 2011-2018
  • DXA
  • Interaction term analysis

Main finding

As reported in the abstract

Body fat distribution
  • Both MUL and MUO had increased android to gynoid fat ratio vs MHL and metabolically healthy with obesity (MHO), respectively
  • Total fat and android fat higher in MUL vs MHL, in men and women
  • Gynoid fat higher in MUL men but not women
  • MUO had similar total fat but lower gynoid fat vs MHO, in men and women
  • Android fat significantly higher in male MUO but not female MUO

Observational data: associations, not effects.

Original publication

Differences in fat distribution between metabolically unhealthy people with normal weight versus obesity, NHANES 2011–2018. BMJ Open Diabetes Res Care. Published 28 May 2025. doi:10.1136/bmjdrc-2025-005118

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