Medical Social Impact from Obesity Subtypes, related Biomarkers & Heterogeneity; Toward a Molecular Epidemiological Classification of the Obesity

The talks about obesity subtypes based on the relationship with biochemical and molecular markers, as well as heterogeneity of four obesity subtypes; metabolically healthy obese (MHO); metabolically abnormal obese (MAO); metabolically obese with normal weight (MONW), and sarcopenic obese (SO). However, there are more than four causes of obesity that can be fit in one of the four classes of obesity. For that reason, we consider is more convenient to talk about types of obesity instead of subtypes and subtypes of obesity for all causes that could fit in one of the four groups. Some causes are monogenic, multigenic, hormonal and multifactorial although we can recognize eleven pure genetically variants or subtypes obesity, most hospitals, especially in the third world, an algorithm is not applied to make a differential and accurate diagnosis of the patient with obesity. Many syndromes or monogenic o polygenic forms such as metabolically healthy obese, metabolically abnormal obese, metabolically obese with normal weight, or sarcopenic obese are misdiagnosed or poorly treated, because they do not have the expertise to detect them. Certainly, in cases, an overlap exists, with genes related to different forms of obesity and subtypes, they have not been described, but they are probably patients with severe morbid obesity in childhood and with a reserved prognosis due to co-morbidities, such as cardiovascular problems, including some may be cases incompatible with life as abortions. This field frontier has not been explored in the world.