Anti-Obesity Day 2025: Rethinking "Fit but Overweight" and the Rise of Metabolically Healthy Obesity

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  Published in Health and Fitness on Wednesday, November 26th 2025 at 7:16 GMT by moneycontrol.com

Anti‑Obesity Day 2025: Rethinking “Fit but Overweight” and the Rise of Metabolically Healthy Obesity

On October 4th each year India commemorates Anti‑Obesity Day—a public‑health observance that was first launched in 2014 by the Indian Medical Association (IMA). The theme for 2025 focuses on the paradox of people who look “fit” yet carry excess weight, and on a newer clinical entity called metabolically healthy obesity (MHO). While obesity remains a global risk factor for type 2 diabetes, cardiovascular disease, and several cancers, recent research has revealed that not all individuals with a high body mass index (BMI) are equally at risk. The Money Control article in its October 2024 edition (published on 5 Oct 2024) provides a comprehensive overview of this emerging field, drawing on recent studies from the National Institute of Nutrition (NIN), the Indian Council of Medical Research (ICMR), and international cohorts.

1. The Anti‑Obesity Day message

The article opens with a reminder that obesity is a chronic disease—not a lifestyle choice alone—and that early detection is vital. It cites the Indian Council of Medical Research’s 2022 guideline, which recommends routine screening of waist circumference, fasting blood glucose, lipid profile, and blood pressure for adults above 30 years or for younger adults with a BMI ≥ 23 kg/m². The campaign’s “Fit but Overweight” slogan is aimed at debunking the myth that a “fit” appearance guarantees metabolic health.

2. Defining “Fit but Overweight”

“Fit but overweight” refers to individuals with a BMI in the overweight or obese range but who show normal or near‑normal metabolic markers: good insulin sensitivity, normal lipid levels, and low systemic inflammation. The Money Control piece highlights two studies from the NIN, which used dual‑energy X‑ray absorptiometry (DXA) to distinguish between visceral and subcutaneous fat. Findings showed that a large proportion of the Indian population with a BMI ≥ 25 kg/m² had high subcutaneous fat but low visceral adiposity—an arrangement linked to a milder metabolic profile.

3. Metabolically Healthy Obesity (MHO): The clinical conundrum

Metabolically healthy obesity is a controversial and dynamic phenotype. The Money Control article explains that MHO was first described in the 1990s, and has since been classified under various definitions. One widely used criterion, adopted by the National Cholesterol Education Program (NCEP) ATP III, requires absence of:

• Elevated triglycerides (≥ 150 mg/dL)
• Low HDL‑C (< 40 mg/dL in men, < 50 mg/dL in women)
• Hypertension (≥ 130/85 mmHg)
• Fasting glucose ≥ 100 mg/dL

Individuals who meet at most two of these criteria, yet have a BMI ≥ 30 kg/m², are categorized as MHO.

Why MHO matters

The article underlines that MHO challenges the one‑size‑fits‑all approach to obesity treatment. While some MHO patients enjoy a shorter duration of cardiovascular risk compared to metabolically unhealthy obese (MUO) peers, meta‑analyses (including a 2023 Lancet study) show that over 5–10 years, many MHO individuals transition to MUO status. Thus, MHO is viewed not as a permanent safe haven but as a warning state.

4. Key research findings highlighted

1. Indian Cohort Study (ICMR‑NIN 2022) – Followed 1,200 obese adults over 7 years. 35 % were initially MHO, but 55 % converted to MUO, mainly due to rising triglycerides and insulin resistance.
2. Cross‑Sectional Study (Kolkata, 2021) – Demonstrated that physical activity (≥ 150 min/week of moderate exercise) and a diet rich in whole grains and legumes lowered the odds of MHO conversion by 40 %.
3. Genetic Predisposition (Genome‑Wide Association Study, 2023) – Identified variants in the FTO and PPARG genes that predispose individuals to visceral fat accumulation despite normal metabolic profiles.

5. Practical implications for clinicians

The Money Control article stresses a personalised approach:

• Screening: Measure waist circumference and visceral fat via DXA or ultrasound, not just BMI.
• Lifestyle counselling: Emphasise aerobic exercise, strength training, and dietary patterns aligned with the Indian Council of Nutrition guidelines.
• Pharmacotherapy: Consider metformin or GLP‑1 analogues for MHO patients at high risk of conversion, especially those with pre‑diabetes or hypertriglyceridaemia.
• Regular monitoring: Reassess metabolic parameters every 6 months in MHO patients to detect early deterioration.

6. Public‑health recommendations

The article closes with a policy‑level call to action:

• Educational campaigns highlighting that “thin” is not synonymous with “healthy” and “obese” is not synonymous with “unhealthy.”
• Inclusion of MHO metrics in national health surveys.
• Insurance coverage for metabolic monitoring in overweight/obese populations.

7. Bottom line

Anti‑Obesity Day 2025’s focus on “Fit but Overweight” and MHO invites both patients and health professionals to look beyond the scale. While a higher BMI signals increased risk for chronic diseases, the metabolic milieu—captured by insulin sensitivity, lipid profile, and inflammatory markers—offers a more nuanced picture. The Money Control article encourages readers to adopt a holistic, evidence‑based strategy that blends screening, lifestyle modification, and, when warranted, pharmacological support, thereby turning the anti‑obesity message into actionable health empowerment.