Nonobese individuals who have metabolic complications related to obesity, called metabolically obese normal weight (MONW), need prevention due to higher risk of developing type 2 diabetes and cardiovascular diseases. Optimal treatment should include exercise training, dietary behavior modification, and, if these measures prove insufficient or unsatisfactory, also pharmacotherapy (metformin, lipid-lowering drugs, and antihypertensive). The issue of early identification of people who need special prevention, due to increased mortality connected to type 2 diabetes and cardiovascular diseases, is particularly important and requires further studies.