Is it possible to be metabolically healthy and overweight or obese? In this episode, we discuss the science of what makes fat healthy or unhealthy. We discuss how metabolic dysfunction in fat tissue can affect the rest of the body. We also review evidence pertaining to the “obesity paradox” and explore explanations for the associations of body mass index (BMI) and changes in the risk of disease complications and mortality. We discuss how metrics of central obesity can be used to obtain a better picture of an individual’s metabolic health. Lastly, we discuss the critical link between exercise capacity and future health, as well as how to begin to transform our existing fat stores into a healthier state.