Results:

Of the 18 070 individuals with complete data at baseline, 1805 (10%) were MHO (mean age 38±11 years) and 3047 were MHNW (mean age 35±11 years). After a median follow-up of 15 years, interquartile range 10–17, 80% of MHO vs 68% of MHNW developed at least one cardiometabolic risk factor (P< 0.001). In multivariate analysis, MHO individuals who gained⩾ 10% of their body weight were more likely to have developed metabolic complications compared to MHO individuals that did not gain weight (P= 0.001 for 10–15%, P< 0.001 for> 15% weight gain). The risk for the secondary composite end point was similar between MHO and MHNW, number of events 218/1805 vs 217/3048 for MHO and MHNW, respectively,(hazard ratio: 1.16, 95% confidence interval: 0.96–1.40).

Conclusions:

MHO are more likely to develop metabolic complications than MHNW, especially if they gain weight.