We argue that despite inconsistencies in the definition , patterns across studies clearly show that healthy obesity is a state of intermediate disease risk .
Expert commentary : Given the current state of population -level evidence , we conclude that obesity and metabolic dysfunction are inseparable and that healthy obesity is best viewed only as a state of relative health but not of absolute health .
INTRODUCTION Obesity is a top public health priority but interventions to reverse the condition have had limited success .
About one-in-three obese adults are free of metabolic risk factor clustering and are considered ' healthy ' , and much attention has focused on the implication s of this state for obesity management .
Subcutaneous adipose tissue remodeling during the initial phase of weight gain induced by overfeeding in humans.
CONTEXT Deciphering the early processes occurring in adipose tissue during weight gain is a major issue for underst and ing the development of fat mass and obesity . Experimental overfeeding in humans is a unique situation to tackle these events . OBJECTIVE Our aim was to identify the pathways involved in sc adipose tissue remodeling during the initial phase of weight gain . RESEARCH DESIGN AND METHODS Forty-four healthy men were involved in an overfeeding protocol with a lipid-enriched diet ( + 760 kcal/d ) for 2 months .  Subcutaneous abdominal adipose tissue biopsies were taken for histology , transcriptomics , and Western blotting in the basal state , after 14 d , and at the end of the protocol . RESULTS Overfeeding significantly increased body weight ( + 2.5 kg ) and fat mass . Reorganization of gene expression patterns occurred in adipose tissue with an up-regulation of numerous genes involved in lipid metabolism and storage , followed by clusters of genes related to angiogenesis and extracellular matrix remodeling . Histological examination showed increased microvascular density and connective tissue deposition after 56 d of overfeeding , with no changes in the number of macrophages or inflammatory cells . Inhibition of the canonical Wnt/β-catenin signaling pathway and induction of the renin-angiotensin system might be implicated in the remodeling of sc adipose tissue . CONCLUSIONS We characterize the coordinated and time-dependent processes that occur in human adipose tissue during the early phase of weight gain in healthy subjects and identify pathways representing potential targets in pathologies of adipose development , including obesity
We argue that despite inconsistencies in the definition , patterns across studies clearly show that healthy obesity is a state of intermediate disease risk .
Expert commentary : Given the current state of population -level evidence , we conclude that obesity and metabolic dysfunction are inseparable and that healthy obesity is best viewed only as a state of relative health but not of absolute health .
INTRODUCTION Obesity is a top public health priority but interventions to reverse the condition have had limited success .
About one-in-three obese adults are free of metabolic risk factor clustering and are considered ' healthy ' , and much attention has focused on the implication s of this state for obesity management .