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Disorders like diabetes and obesity have reached pandemic proportions globally. However, this problem is a little different in some tropical countries especially in the south Asian region. Countries like India and China have the leading number of people living with type 2 diabetes mellitus but paradoxically a much lower number of people with obesity (as defined by body mass index). This paradox is partly explained by the unique thin-fat phenotype prevalent in this region. Though this concept was described about 15 years ago, further evidence regarding its prevalence, pathophysiology, diagnosis, cardiometabolic risks, treatment, and implications for policy change are still emerging. The thin-fat phenotype is known by several other names in the scientific literature including normal weight obesity, metabolic obesity, metabolically unhealthy non-obese, etc. It is defined as an individual who has normal body weight (as …