In South Africa obesity is common among black women, especially urban women. Low frequencies of hypertension, hyperlipidaemia and hyperglycaemia, usually associated with obesity, have been reported in obese black women. This gave rise to the term 'healthy' obesity. The gynoid (upper body) type of obesity, also often referred to as 'healthy' obesity, is typical in South African black women, accentuating the 'healthy' obese condition. The lower risk associated with the 'healthy' obesity questions the necessity of treatment of this condition. Relatively high plasma fibrinogen levels have, however, been observed in the South African black population. The positive association reported between obesity and plasma fibrinogen, motivated this investigation into the validity of the term 'healthy' obesity. Black women were characterised as 'healthy' obese according to the following criteria: (1) body mass index > 30kg/m2, (2) blood pressure cl45/95 mmHg, (3) serum total cholesterol < 5.2 mmol/L, (4) serum triglycéride < 2.0mmol/L, (5) serum glucose < 6.0mmol/L. Serum lipoproteins, glucose? blood pressure and anthropometry were measured with standard methods and plasma fibrinogen with the method of Clauss. Plasma fibrinogen levels were increased in these women. The increased plasma fibrinogen probably will not contribute to coronary heart disease, because the mortality rate from coronary heart disease in this population is still low. The increased plasma fibrinogen levels may, however, contribute to the high stroke incidence in this population. Thus, the increased plasma fibrinogen levels changed the 'healthy' obesity to a state of increased risk for stroke. Until more conclusive evidence is available that 'healthy' obesity is indeed healthy, the term should not be used by lay health practitioners. Advice to correct lifestyle remains mandatory in these women. © Pearson Professional Ltd 1996.