The “metabolically-obese,” normal-weight individual
Abstract
A great many disorders including maturity-onset (type II) diabetes, hypertension, and hypertriglyceridemia are frequently associated with adult-onset obesity and improve with caloric restriction. It is the premise of this brief review that there are patients with these disorders who are not obese according to standard weight tables or other readily-available criteria; but who would also respond favorably to caloric restriction. It is proposed that such individuals might be characterized by hyperinsulinism and possibly an increase in fat cell size compared to patients of similar age, height, and weight and/or to themselves at an earlier time. The possibility is also discussed that inactivity is a contributing factor in some of these individuals and that for them, the appropriate therapy might be exercise.
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Not all adipose tissue expansion is necessarily associated with pathological changes.
“However, not all AT expansion is necessarily associated with pathological changes.”
From Adipose tissue remodeling and obesity (2011) · cites this paper as [2]
Cites
Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance.
National Diabetes Data Group (1979) · Diabetes · doi:10.2337/diab.28.12.1039 · Cited by 4,909 · see citing works
Reisin, E., Abel, R., Modan, M., Silverberg, D. S., Eliahou, H. E., & Modan, B. (1978) · New England Journal of Medicine · doi:10.1056/nejm197801052980101 · Cited by 759 · see citing works
Endocrine and Metabolic Effects of Experimental Obesity in Man
Sims, E. A. H., Danforth, E., Horton, E. S., Bray, G. A., Glennon, J. A., & Salans, L. B. (1973) · Elsevier eBooks · doi:10.1016/b978-0-12-571129-6.50016-6 · Cited by 563 · see citing works
Olefsky, J. M., Reaven, G. M., & Farquhar, J. W. (1974) · Journal of Clinical Investigation · doi:10.1172/jci107560 · Cited by 510 · see citing works
Biliary lipid secretion in cholesterol gallstone disease. The effect of cholecystectomy and obesity.
Shaffer, E. A., & SMALL, D. M. (1977) · Journal of Clinical Investigation · doi:10.1172/jci108705 · Cited by 346 · see citing works
Studies of Human Adipose Tissue ADIPOSE CELL SIZE AND NUMBER IN NONOBESE AND OBESE PATIENTS
Salans, L. B., Cushman, S. W., & Weismann, R. E. (1973) · Journal of Clinical Investigation · doi:10.1172/jci107258 · Cited by 325 · see citing works
Effect of exercise and physical fitness on serum lipids and lipoproteins
Lopez‐S, A., Vial, R., Balart, L., & ARROYAVE, G. (1974) · Atherosclerosis · doi:10.1016/0021-9150(74)90073-2 · Cited by 291 · see citing works
The effect of physical training on insulin production in obesity
Björntorp, P. A., de Jounge, K., Sjöström, L., & Sullivan, L. (1970) · Metabolism · doi:10.1016/0026-0495(70)90020-x · Cited by 281 · see citing works
Relationship of Childhood Weight Status to Morbidity in Adults
Abraham, S., Collins, G., & Nordsieck, M. (1971) · HSMHA Health Reports · doi:10.2307/4594149 · Cited by 271 · see citing works
Effects of long-term physical training on body fat, metabolism, and blood pressure in obesity
Krotkiewski, M., Mandroukas, K., Sjöström, L., Sullivan, L., Wetterqvist, H., & Björntorp, P. A. (1979) · Metabolism · doi:10.1016/0026-0495(79)90018-0 · Cited by 247 · see citing works
Andres, R. (1971) · Medical Clinics of North America · doi:10.1016/s0025-7125(16)32479-8 · Cited by 232 · see citing works
Carbohydrate and lipid metabolism in middle-aged, physically well-trained men
Björntorp, P. A., Fahlén, M., Grimby, G., Gustafson, A., Holm, J., Renström, P. A. F. H., & Scherstén, T. (1972) · Metabolism · doi:10.1016/0026-0495(72)90034-0 · Cited by 231 · see citing works
Risk Factors for the Development of Cholelithiasis in Man
Bennion, L. J., & Grundy, S. M. (1978) · New England Journal of Medicine · doi:10.1056/nejm197811302992205 · Cited by 196 · see citing works
Glucose Intolerance During Decreased Physical Activity in Man
Lipman, R. L., Raskin, P., Love, T., Triebwasser, J. H., Lecocq, F. R., & Schnure, J. J. (1972) · Diabetes · doi:10.2337/diab.21.2.101 · Cited by 195 · see citing works
Changes of body composition in man during maturity and their nutritional implications.
Brozek, J. M. (1952) · PubMed · Cited by 170 · see citing works
Effect of diet composition on the hyperinsulinemia of obesity
Grey, N., & Kipnis, D. M. (1971) · New England Journal of Medicine · doi:10.1056/nejm197110072851504 · Cited by 156 · see citing works
Einarsson, K., Hellström, K., & Kallner, M. (1974) · Journal of Clinical Investigation · doi:10.1172/jci107876 · Cited by 126 · see citing works
Björntorp, P. A., Berchtold, P., Grimby, G., Lindholm, B., Sanne, H., Tibblin, G., & Wilhelmsen, L. (1972) · Acta Medica Scandinavica · doi:10.1111/j.0954-6820.1972.tb04843.x · Cited by 91 · see citing works
Self-citationInsulin Secretion in Relation to Adipose Tissue in Men
Björntorp, P. A., Berchtold, P., & Tibblin, G. (1971) · Diabetes · doi:10.2337/diab.20.2.65 · Cited by 91 · see citing works
Self-citationInsulin and glucose responses during bed rest with isotonic and isometric exercise
Dolkas, C. B., & GREENLEAF, J. E. (1977) · Journal of Applied Physiology · doi:10.1152/jappl.1977.43.6.1033 · Cited by 76 · see citing works
DOES HYPERGLYCÆMIA OR HYPERINSULINÆMIA CHARACTERISE THE PATIENT WITH CHEMICAL DIABETES ?
Reaven, G., Olefsky, J. M., & Farquhar, J. (1972) · The Lancet · doi:10.1016/s0140-6736(72)90977-4 · Cited by 76 · see citing works
GLUCOSE TOLERANCE, AGE, AND CIRCULATING INSULIN
Chlouverakis, C., Jarrett, R. J., & KEEN, H. (1967) · The Lancet · doi:10.1016/s0140-6736(67)92774-2 · Cited by 71 · see citing works
GALLBLADDER DISEASE IN HYPERLIPOPROTEINqMIA
Einarsson, K. (1975) · The Lancet · doi:10.1016/s0140-6736(75)92831-7 · Cited by 70 · see citing works
INSULIN EXCESS AS THE INITIAL LESION IN DIABETES
Jackson, W. P. U., Mieghem, W. V., & Keller, P. (1972) · The Lancet · doi:10.1016/s0140-6736(72)91221-4 · Cited by 66 · see citing works
Bernstein, R. S., Grant, N., & KIPNIS, D. M. (1975) · Diabetes · doi:10.2337/diab.24.2.207 · Cited by 39 · see citing works
GLUCOSE TOLERANCE, PLASMA LIPIDS AND SERUM INSULIN IN PATIENTS WITH ISCHAEMIC HEART DISEASES
Christiansen, I. S., Deckert, T., Kjerulf, K., Midtgaard, K., & WORNING, H. (1968) · Acta Medica Scandinavica · doi:10.1111/j.0954-6820.1968.tb02458.x · Cited by 36 · see citing works
Malherbe, C., Marc De Gasparo, B., Berthet, P., Hertogh, R. D., & Hoet, J. J. (1971) · European Journal of Clinical Investigation · doi:10.1111/eci.1971.1.4.265 · Cited by 30 · see citing works
Studies on the natural history of asymptomatic diabetes in young people
Fajans, S. S., Floyd, J. C., Pek, S., et al. (1973) · Metabolism · doi:10.1016/0026-0495(73)90183-2 · Cited by 21 · see citing works
Evaluation of Age-adjusted Criteria for Potential Diabetes
O’Sullivan, J. B., & Mahan, C. M. (1971) · Diabetes · doi:10.2337/diab.20.12.811 · Cited by 17 · see citing works
Does age affect glucose tolerance?
Gm, R. (1977) · PubMed · Cited by 17 · see citing works
Werbin, B., Tamir, I., Heldenberg, D., et al. (1977) · Clinica Chimica Acta · doi:10.1016/0009-8981(77)90116-4 · Cited by 4 · see citing works
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Wajchenberg, B. L. (2000) · Endocrine Reviews · doi:10.1210/edrv.21.6.0415 · Cited by 2,961 · see citing works
Pathophysiology of human visceral obesity: an update
Tchernof, A., & Després, J.-P. (2013) · Physiological Reviews · doi:10.1152/physrev.00033.2011 · Cited by 2,583 · see citing works
Adipose tissue remodeling and obesity
Sun, K., Kusminski, C. M., & Scherer, P. E. (2011) · Journal of Clinical Investigation · doi:10.1172/jci45887 · Cited by 1,941 · see citing works
Chait, A., & den Hartigh, L. J. (2020) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2020.00022 · Cited by 1,529 · see citing works
The metabolically obese, normal-weight individual revisited.
Ruderman, N., Chisholm, D., Pi-Sunyer, X., & Schneider, S. (1998) · Diabetes · doi:10.2337/diabetes.47.5.699 · Cited by 893 · see citing works
Self-citationKalinkovich, A., & Livshits, G. (2017) · Ageing Research Reviews · doi:10.1016/j.arr.2016.09.008 · Cited by 882 · see citing works
Goodpaster, B. H., Krishnaswami, S., Resnick, H., Kelley, D. E., Haggerty, C., Harris, T. B., Schwartz, A. V., Kritchevsky, S., & Newman, A. B. (2003) · Diabetes Care · doi:10.2337/diacare.26.2.372 · Cited by 619 · see citing works
Association of Weight Status With Mortality in Adults With Incident Diabetes
Carnethon, M. R., De Chavez, P. J. D., Biggs, M. L., Lewis, C. E., Pankow, J. S., Bertoni, A. G., Golden, S. H., Liu, K., Mukamal, K. J., Campbell-Jenkins, B., et al. (2012) · JAMA · doi:10.1001/jama.2012.9282 · Cited by 567 · see citing works
Gluttony, sloth and the metabolic syndrome: a roadmap to lipotoxicity
Unger, R. H., & Scherer, P. E. (2010) · Trends in Endocrinology & Metabolism · doi:10.1016/j.tem.2010.01.009 · Cited by 436 · see citing works
Endotrophin triggers adipose tissue fibrosis and metabolic dysfunction
Sun, K., Park, J., Gupta, O. T., Holland, W. L., Auerbach, P., Zhang, N., Goncalves Marangoni, R., Nicoloro, S. M., Czech, M. P., Varga, J., et al. (2014) · Nature Communications · doi:10.1038/ncomms4485 · Cited by 364 · see citing works
Younes, R., & Bugianesi, E. (2019) · Seminars in Liver Disease · doi:10.1055/s-0038-1677517 · Cited by 235 · see citing works
Metabolic and Behavioral Characteristics of Metabolically Obese but Normal-Weight Women
Conus, F., Allison, D. B., Rabasa-Lhoret, R., St-Onge, M., St-Pierre, D. H., Tremblay-Lebeau, A., & Poehlman, E. T. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-0265 · Cited by 215 · see citing works
The relationship of omental and subcutaneous adipocyte size to metabolic disease in severe obesity
O'Connell, J., Lynch, L., Cawood, T. J., Kwasnik, A., Nolan, N., Geoghegan, J., McCormick, A., O'Farrelly, C., & O'Shea, D. (2010) · PLoS ONE · doi:10.1371/journal.pone.0009997 · Cited by 211 · see citing works
Longevity, lipotoxicity and leptin: the adipocyte defense against feasting and famine
Unger, R. H. (2005) · Biochimie · doi:10.1016/j.biochi.2004.11.014 · Cited by 184 · see citing works
Adipose tissue and metabolic syndrome: too much, too little or neither
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Mathew, H., Farr, O. M., & Mantzoros, C. S. (2016) · Metabolism · doi:10.1016/j.metabol.2015.10.019 · Cited by 182 · see citing works
Ioachimescu, A. G., Brennan, D. M., Hoar, B. M., & Hoogwerf, B. J. (2010) · Obesity · doi:10.1038/oby.2009.453 · Cited by 147 · see citing works
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Zhu, T., & Goodarzi, M. O. (2022) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgab757 · Cited by 126 · see citing works
Body Composition in Asians and Caucasians
Haldar, S., Chia, S. C., & Henry, C. J. (2015) · Advances in Food and Nutrition Research · doi:10.1016/bs.afnr.2015.07.001 · Cited by 100 · see citing works
Lange, M., Nadkarni, D., Martin, L., Newberry, C., Kumar, S., & Kushner, T. (2023) · Hepatology Communications · doi:10.1097/hc9.0000000000000212 · Cited by 49 · see citing works
Adipose Tissue Dysfunction: A Multistep Process
Sun, K., & Scherer, P. E. (2010) · Research and Perspectives in Endocrine Interactions · doi:10.1007/978-3-642-13517-0_6 · Cited by 23 · see citing works
Jacob, E., Moura, A., & Avery, A. (2024) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2024.08.001 · Cited by 7 · see citing works
- Authors
- Ruderman, N. B., Schneider, S. H., & Berchtold, P.
- ORCID
- Ruderman, N B
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 1981-08
- Volume
- 34
- Issue
- 8
- Pages
- 1617-1621
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W1946178666
- Cited by
- 545
- References
- 31
- Citations by year
- 2026: 18 · 2025: 15 · 2024: 20 · 2023: 17 · 2022: 15 · 2021: 23 · 2020: 38 · 2019: 20 · 2018: 32 · 2017: 27 · 2016: 29 · 2015: 30 · 2014: 29 · 2013: 35 · 2012: 27
- FWCI
- 1.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (T32AM007201)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- type 2 diabetes, hypertension, hypertriglyceridemia, caloric restriction, hyperinsulinism, adipocyte size, physical inactivity, exercise therapy, obesity
- MeSH terms
- Adipose Tissue, Aging, Body Weight, Diabetes Mellitus, Diet, Reducing, Physical Exertion, Humans, Hyperinsulinism, Hyperlipidemias, Obesity, Reference Values, Triglycerides
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