News & Commentary

Obesity Paradox May Help Women


Overweight or slightly obese women diagnosed with heart failure may be pleasantly surprised to learn that the prognosis is not as bad as they think, thanks to the obesity paradox. The obesity paradox is that in some groups of people being heavy seems to be associated with beneficial health effects and in this case, the benefit is quite significant, according to a study in JACC: Heart Failure.

The heavier women outlive normal-weight women by as much as 16%. Researchers at the Cleveland Clinic Women’s Cardiovascular Center looked at 4,000 people with heart failure. Normal weight is a body mass index (BMI) of 18.5 to 24.9; overweight, 25 to 29.9; and obese, ≥30.

The obesity paradox in this instance applies only to women, Leslie Cho, MD, the lead author of the study said. Men who are overweight or mildly obese should lose weight to strengthen heart function.

Other studies have also found that being heavy may have some protective influence once people have heart failure. One explanation is that heart failure puts people in a catabolic state and that extra weight gives people some metabolic reserve that buffers them against heart failure’s biological effects.

But these findings don’t exonerate being overweight or obese as a risk factor for getting heart failure in the first place. Results from the Framingham Heart Study have shown that for every 1 kg/m2 increment in BMI, the risk of heart failure ratchets up by 5% for men and 7% for women.