Now many people will be sad to say, I am not fat, I just have more fat, but there are about 30% of obese people do not increase the risk of obesity-related metabolic syndrome, this type of obesity is often called metabolic health obesity. In ancient times, fat is beautiful: spring cold gives bath Huaqing pool, hot spring water smooth wash gel fat (all oil). Now the sad fat person will say, I am not fat, I just have more fat! There is no doubt that the incidence of obesity is increasing, especially among adolescents, and that obesity significantly increases the risk of metabolism-related diseases and certain tumors. However, there are still approximately 30% of obese individuals who are not at increased risk for obesity-related metabolic syndrome, a category commonly referred to as metabolically healthy obesity. Metabolically healthy obesity, which has only recently become widely recognized, is not associated with metabolic syndrome, and is more common in women and young adults. There are no accepted criteria for identifying metabolically healthy obesity, but there is evidence that this type of obesity does not have the typical obesity-related metabolic abnormalities, including insulin resistance and abnormal glucose tolerance, hypertension, and dyslipidemia. Obese individuals are more likely to develop diabetes and cardiovascular disease, but weight gain may not be responsible for these complications, but rather may be due to the persistent chronic inflammatory state of the obese organism. By comparing the serum cytokine expression profiles of metabolically healthy and metabolically abnormal obese individuals, it has been found that the former have lower serum concentrations of complement C3, C-reactive protein, tumor necrosis factor and interleukin-6, higher levels of lipocalin and lower numbers of leukocytes, and that lipocalin has increased insulin sensitivity, anti-atherosclerotic and anti-inflammatory effects. It suggests that chronic and persistent inflammation may be a key factor in the development of obesity-related complications, which may be the reason why some obese people do not develop metabolic syndrome. Human adipose tissue consists mainly of subcutaneous fat, visceral fat (including omental fat and intrahepatic fat). Of these, subcutaneous adipose tissue has little metabolic activity, whereas visceral adipose tissue is now thought to be an active endocrine organ, secreting approximately 200 adipokines that play an important role in the metabolic complications associated with obesity. Visceral adipose tissue may be the main tissue involved in insulin resistance and chronic inflammation, which explains the fact that there is less visceral fat in metabolically healthy obese individuals, and therefore, it has been proposed that waist circumference is a more accurate definition of obesity than body mass index (BMI). It has been suggested that people who are metabolically healthy and obese in childhood may maintain this healthy obesity in adulthood. However, childhood obesity is more complex than adult obesity, requiring consideration of demographic and economic levels as well as psychological factors. The criteria for determining metabolically healthy obesity in children also cannot be replicated in adults, and the identification of metabolically healthy obesity in the child and adolescent population should primarily consider insulin resistance and risk factors for cardiovascular metabolic disease (blood pressure, lipids, and glucose). The development of a clear definition and a deeper understanding of the underlying biological mechanisms that can identify high-risk groups at risk for complications from the obese population would allow for more targeted interventions for obesity. It is true that some fat people are healthy, but this does not allow us to relax our vigilance about obesity, which is at least a subhealthy state, and it is still important to pay attention to a regular diet and a healthy lifestyle, especially in adolescents who are already overweight and obese.