Normal Weight Obesity Overview and Update: A narrative review

This review synthesizes current knowledge on Normal Weight Obesity (NWO), a condition characterized by excess body fat despite having a normal Body Mass Index (BMI). It highlights recent findings on diagnostic methods, pathophysiological mechanisms, and health implications associated with NWO.

Individuals with NWO have an increased risk of developing chronic inflammation, cardiometabolic disorders, insulin resistance, and sarcopenia. Genetic factors, including polymorphisms in IL-6, IL-1Ra, IL-15Ra, and MTHFR genes, play a significant role in determining susceptibility. Lifestyle behaviors, reduced physical activity and frequent intake of ultra-processed foods, further elevate metabolic risks. Advanced diagnostic techniques, particularly Dual-Energy X-ray Absorptiometry (DXA), are essential for accurate identification of NWO, as traditional BMI measurements fail to adequately detect this phenotype.

Recognition and management of NWO require shifting from BMI-based classifications to detailed body composition analyses. Incorporating DXA into clinical practice is essential for accurately identifying individuals at metabolic risk. Further research should develop targeted strategies for preventing and treating this specific obesity phenotype.

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