Researchers in Finland have found 16 pairs of identical twins – with one obese twin per pair.
And a study of the twins is throwing up "surprising" results, they say.
The researchers believe the twins are unlikely to suffer from any strong genetic causes of obesity.
Their study is seeking to identify the impact of obesity.
But, according to the latest findings, half the obese twins are suffering metabolic damage while the other half remained as "healthy" as their lean siblings.
Those who were becoming unhealthy had high blood pressure, high levels of fat in their circulation and increased resistance to insulin, they report in the journal Diabetologia.
The twins were aged in their 20s and 30s. The researchers say it is possible the "metabolically healthy" obese twins may suffer problems if they fail to lose weight in the coming years.
The study pin-points the energy-creating mitochondria in the cells as a key factor in keeping obese twins healthy.
Researcher Dr Kirsi Pietiläinen, of the University of Helsinki, Helsinki, Finland, said the study might help identify ways to develop drugs to combat the ill effects of obesity.
Diabetologia 07 October 2013; DOI: 10.1007/s00125-013-3066-y
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