Sponholtz TR, et al. - Researchers evaluated the potential interaction—on both additive and multiplicative scales—between obesity and metabolic health in their associations with incident cardiometabolic outcomes, chronic kidney disease (CKD), and cardiovascular disease (CVD) over 30 years in 3,632 Framingham Heart Study offspring cohort participants (mean age, 50.8 years; 53.8% women). In addition, they explored potential differences in the associations of variability in body mass index and metabolic health–related measures with these outcomes in accordance to obesity status and metabolic health status, respectively. In all, there was no evidence to suggest an interaction between obesity and metabolic health status in their associations with incident diabetes mellitus, hypertension, cardiovascular disease, or chronic kidney disease. Upon examination of the health consequences of variability in body mass index and metabolic health with study outcomes, higher risk of incident obesity, metabolically unhealthy state, diabetes mellitus, and hypertension were observed in correlation with body mass index variability among participants without obesity. In contrast, among metabolically unhealthy patients, an association of metabolic health variability with cardiovascular disease was observed, but not with risk of other outcomes.