Scientists redefine obesity with discovery of two major subtypes

A team led by Van Andel Institute scientists has identified two distinct types of obesity with physiological and molecular differences that may have lifelong consequences for health, disease and response to medication.

The findings, published today in the journal Nature Metabolism, offer a more nuanced understanding of obesity than current definitions and may one day inform more precise ways to diagnose and treat obesity and associated metabolic disorders.

The study also reveals new details about the role of epigenetics and chance in health and provides insights into the link between insulin and obesity.

“Nearly two billion people worldwide are considered overweight and there are more than 600 million people with obesity, yet we have no framework for stratifying individuals according to their more precise disease etiologies,” said J. Andrew Pospisilik, Ph.D., chair of Van Andel Institute’s Department of Epigenetics and corresponding author of the study. “Using a purely data-driven approach, we see for the first time that there are at least two different metabolic subtypes of obesity, each with their own physiological and molecular features that influence health. Translating these findings into a clinically usable test could help doctors provide more precise care for patients.”

Currently, obesity is diagnosed using body mass index (BMI), an index correlated to body fat that is generated by comparing weight in relation to height. It is an imperfect measure, Pospisilik says, because it doesn’t account for underlying biological differences and can misrepresent an individual’s health status.

Using a combination of laboratory studies in mouse models and deep analysis of data from TwinsUK, a pioneering research resource and study cohort developed in the United Kingdom, Pospisilik and his collaborators discovered four metabolic subtypes that influence individual body types: two prone to leanness and two prone to obesity.

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