The concept of normal weight obesity refers to the segment of the population that is considered normal weight per Body Mass Index (BMI) calculation but possessing excess fat or a high body fat percentage while not yet exhibiting the harmful effects of the excess fat.


To differentiate Normal Weight Obesity (NWO) from Metabolically Obese Normal Weight (MONW) the earliest onset of cardiometabolic dysregulation must be evaluated. The two earliest measurable parameters of dysregulation are insulin resistance and low-grade systemic inflammation. 1, 2 The occurrence of these dysregulations is affected by the amount of fat on the body; particularly abdominal fat (visceral fat) of which is the most inflammatory fat on the body. This type of fat is now known to secrete approximately 400 inflammatory messengers within the body that triggers insulin resistance and inflammation.


Normal Weight Obesity highlights the importance of the need for an updated definition that can be used generally. A definition that is not based upon body weight but a definition that is based upon adiposity (amount of fat). To further complicate matter percent of allowable body fat increases as we age because part of the aging process implicates are higher percentage of allowable body fat.


Ways to calculate body fat percentage include utilization of skinfold calipers, bioelectrical impedance, air plethysmography, hydrostatic plethysmography, isotope dilution techniques, dual x-ray absorptiometry, as well as other methods.


The easiest way to see if you’re at risk for NWO is to measure your waist circumference around your belly button and to compare that to your height. This is known as the waist-to-height ratio or the waist-to-stature ratio. The general healthy cutoff is at level 0.5. Meaning your waist circumference should be less than half of your height.


This article is to serve as awareness to people that may be normal weight but also have excess fat. Weight is the least important number when evaluating overall health. The composition of the body is a reflection of the metabolism and serves as a means of screening for future health risks.

The Metabolism Clinic is established as the destination for weight loss and reversal of diabetes. Based in Charlotte, North Carolina.