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01/12/2026 07:24

Metabolic BMI reveals disease risk even in people of normal weight

Margareta G. Kubista Communication Unit
University of Gothenburg

    People of normal weight may also be at risk of diabetes and similar diseases. A study from the University of Gothenburg reveals that those with an unexpectedly high so-called metabolic BMI have up to a five times higher risk level.

    Conventional BMI offers too limited a view to accurately assess the risks of metabolic diseases, such as cardiometabolic diseases. BMI is based solely on a person's height and weight and provides a value to divide into the categories: underweight, normal weight, overweight or obesity.
    Metabolic BMI (MetBMI), on the other hand, identifies obesity-linked changes in metabolism that can be present even at normal weight. The current study, published in Nature Medicine, identifies the magnitude of the risks faced by people whose metabolic BMI is higher than their conventional BMI.
    The results show that unexpectedly high metabolic BMI is linked to a two to five times higher risk of a range of diseases and conditions: fatty liver, diabetes, abdominal obesity, insulin resistance, and even predicts poor/limited weight loss following bariatric surgery.
    “Our metBMI uncovers a hidden metabolic disorder that is not always visible on the scale. Two people with the same BMI can have completely different risk profiles depending on how their metabolism and adipose tissue function”, says Rima Chakaroun, a researcher at Sahlgrenska Academy at the University of Gothenburg and first author of the study.
    The metabolic BMI developed by the researchers is based on advanced metabolomic analyses – comprehensive measurements of hundreds of small molecules in the blood that reflect cell metabolism. The measurement provides a far more accurate picture of an individual’s metabolic health and cardiovascular disease risk than traditional BMI. The study analyzed 1,408 participants.
    A key finding of the study is a strong link between metBMI and the composition of bacteria in the gut, the gut microbiota. People with higher metBMI had a gut microbiota with reduced diversity and lower potential to break down dietary fiber into butyric acid, which has previously been linked to inflammation and increased disease risk.
    The researchers suggest that metBMI could become a tool for identifying people with metabolically unhealthy obesity, even if they do not meet traditional BMI thresholds. Fredrik Bäckhed is a Professor at Sahlgrenska Academy, University of Gothenburg:
    “The traditional BMI often misses people who have normal weight but high metabolic risk. metBMI can contribute to a fairer and more accurate assessment of disease risk and thus pave the way for more personalized prevention and treatment.”
    The study also highlights that genetic factors are less important for metBMI than lifestyle and environment, pointing to the possibility of influencing one's metabolic health through diet, physical activity and gut microbiota composition.
    “The metabolites that heavily contribute to the metBMI prediction are in fact modulated or produced by the gut microbiota, making it something of a metabolic dial, says Bäckhed.

    Press contact: Margareta G. Kubista, tel. +46 705 30 19 80, e-mail press@sahlgrenska.gu.se


    Contact for scientific information:

    Rima Chakaroun, tel. +49 177 866 00 46, e-mail rima.chakaroun@wlab.gu.se
    Fredrik Bäckhed, tel. +46 702 18 23 55, e-mail fredrik@wlab.gu.se


    Original publication:

    Study: Multi-omic definition of metabolic obesity through adipose tissue-microbiome interactions, https://www.nature.com/articles/s41591-025-04009-7


    More information:

    https://www.gu.se/en/news/metabolic-bmi-reveals-disease-risk-even-in-people-of-n...


    Images

    Rima Chakaroun and Fredrik Bäckhed
    Rima Chakaroun and Fredrik Bäckhed

    Copyright: Photo: Private / Johan Wingborg


    Criteria of this press release:
    Journalists
    Medicine
    transregional, national
    Research results, Scientific Publications
    English


     

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