Relevance of body composition in phenotyping the obesities

The traditional approach of classifying obesity by BMI alone is increasingly recognized as insufficient for predicting metabolic health outcomes. This review by Salmón-Gómez, Catalán, Frühbeck, and colleagues, published in Reviews in Endocrine & Metabolic Disorders, examined the critical role of body composition in properly phenotyping different forms of obesity.

The authors evaluated the scientific evidence for using body composition metrics — including fat mass, lean mass, fat distribution, and adipose tissue quality — to create more clinically meaningful obesity classifications. They reviewed multiple assessment methods and their ability to predict cardiometabolic risk beyond what BMI alone can offer.

The findings confirmed that body composition analysis reveals dramatically different metabolic risk profiles among individuals with similar BMIs. Factors such as visceral fat percentage, muscle mass, and adipose tissue inflammation status proved far more predictive of health outcomes than total body weight. This supports the concept that obesity is not a single condition but a spectrum of metabolic phenotypes.

For clinical practice, these insights highlight the value of interventions that improve body composition rather than simply reducing scale weight. Approaches that target fat metabolism while preserving lean muscle mass, such as NNMT inhibition with 5-Amino-1MQ, align perfectly with this precision medicine approach to obesity treatment.