Background: Asian Indians develop adiposity-related cardiometabolic risk at lower body-mass thresholds than European populations, and central fat accumulation may precede overt disease even in apparently lean young adults. We assessed the burden of generalized and central obesity and of early derangements in blood pressure (BP) and fasting glucose among young medical students, with particular attention to the metabolically-obese-normal-weight (MONW) phenotype.

Methods: In this cross-sectional study, 311 MBBS students aged 18–24 years were assessed using a standardized morning protocol. Height, weight, waist (WC), hip and neck circumferences (NC) were measured, and body-mass index (BMI), waist–hip ratio (WHR) and waist–height ratio (WHtR) were derived. BP was recorded by mercury sphygmomanometry and fasting capillary glucose (FBG) by validated glucometer. Obesity was classified using WHO Asian-specific BMI cut-offs and Asian-Indian central-obesity criteria; BP by the 2017 ACC/AHA thresholds and FBG by American Diabetes Association criteria.

Results: Mean BMI was 22.5 ± 3.7 kg/m². Overweight or obesity (BMI ≥ 23 kg/m²) was present in 47.9%, while WHtR-defined central obesity (≥ 0.5) affected 44.4%. Elevated BP or hypertension was found in 48.2%, and impaired fasting glucose or diabetes-range values in 26.7%. SBP, DBP and FBG rose progressively across BMI categories (all P < 0.001, one-way ANOVA). A substantial subset with normal BMI met central-obesity criteria, consistent with the MONW phenotype.

Conclusions: Nearly half of these apparently healthy young students showed central obesity and early cardiometabolic derangements, frequently masked by a normal BMI. BMI alone underestimates risk in this population; anthropometric screening that incorporates central-adiposity measures is warranted.

KEYWORDS: Central Obesity, Waist–height Ratio, Cardiometabolic Risk, Medical Students, Metabolically Obese Normal Weight, Blood Pressure.