I agree with Sam Klein’s assessment of the research. As long as you don’t have insulin resistance, it means you don’t have systematic inflammation. As I pointed out in my book Toxic Fat published in 2008, another definition of metabolically healthy obese individuals is that they have healthy fat cells. It is only when your fat cells become sick or start to die, that systematic insulin resistance begins to develop and spread from the fat cells to other organs. This is called lipotoxicity.
The most current conventional wisdom among doctors and obesity researchers goes something like this: While people who are obese are at high risk for metabolic syndrome ― a constellation of symptoms that increase the risk for Type 2 diabetes, heart disease and more ― there is also a significant group of obese people who are totally healthy and will remain healthy.