Hormonal
Obesity-associated health risks (such as type 2 diabetes and coronary heart disease) are not determined solely by body mass index (BMI) or total fat mass, but are critically governed by the location of fat deposition (visceral vs. subcutaneous) and genetic variations in adipokine secretion (e.g., adiponectin).
Do not rely on BMI alone to assess your health risks. Focus on waist circumference and metabolic markers (like blood sugar and lipids) because your genetic makeup and where you store fat (belly vs. hips) determine your actual risk for diabetes and heart disease, not just your total weight.
It is becoming clear, however, that the location of fat deposition, variation in the secretion of adipokines and other factors govern whether a particular obese person develops such complications.
Why this rating
The paper is a review citing multiple studies on specific genes (MC4R, PPARG, ADIPOQ) and clinical outcomes, though it notes the complexity of polygenic interactions.
Source
Genetics of obesity and the prediction of risk for health
Andrew J. Walley et al. · Human Molecular Genetics · 2006
DOI 10.1093/hmg/ddl215
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