It is common to find obese people (even morbidly obese people) who are healthier than their condition would normally allow.

 

Working with subjects with a BMI of about 56, a team of researchers investigated the inflammatory and insulin signaling pathways in the patients' visceral adipose tissue. Barbarroja et al. found that the 'healthy' obese lacked an inflammatory response that was found in the unhealthy and insulin-resistant obese.

 

The reason, they suggest, is that there are pathways common to obesity yet unrelated to insulin resistance and pathways that lead to insulin resistance for a similar degree of obesity. It is the inflammation response that affects insulin resistance, through the expression of the cytokines interleukin 1â and interleukin 16.