Hormonal
Lower visceral adipose tissue (VAT) accumulation, rather than total body fatness, is the primary physiological characteristic associated with a normal metabolic profile (high insulin sensitivity, favorable lipid profile) in obese postmenopausal women.
For obese postmenopausal women, achieving a 'normal' metabolic profile is possible even with high total body fat, provided visceral fat accumulation is kept low. This suggests that interventions targeting visceral fat reduction (via diet or exercise) may yield better metabolic outcomes than those focusing solely on total weight loss or BMI reduction.
Our results support the existence of a subgroup of metabolically normal but obese postmenopausal women who display high levels of insulin sensitivity despite having a high accumulation of body fat. This metabolically normal profile is associated with a lower accumulation of visceral adipose tissue and an earlier age-related onset of obesity.
Why this rating
High-quality observational study using gold-standard hyperinsulinemic-euglycemic clamp and CT imaging, though cross-sectional design limits causal inference.
Source
What Are the Physical Characteristics Associated with a Normal Metabolic Profile Despite a High Level of Obesity in Postmenopausal Women?1
Martin Brochu et al. · The Journal of Clinical Endocrinology & Metabolism · 2001
DOI 10.1210/jcem.86.3.7365
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