Recent studies have shown that about 20% of obese subjects are metabolically healthy with no increased risk for development of cardio-vascular disease or type 2 diabetes. This group is characterized by normal metabolic parameters (do not have metabolic syndrome) and by minimal ectopic fat accumulation in the visceral depot, in the liver etc. It is argued that treatment intensity to obtain a weight loss should take the benign form of obesity into account since more active treatments such as pharmacotherapy and surgery may potentially be harmful rather than having a beneficial effect in this subgroup of obese subjects.