News & Commentary

Obesity Paradox? It Doesn’t Exist


The idea has been kicking around for years that being overweight or obese does not necessarily mean a greater chance of getting a heart attack or stroke and that the excess pounds may even have a protective effect.

But a British study of 296,535 people added to the evidence that—sorry folks—the so-called obesity paradox is more wishful thinking than true. There’s just no escaping that many of us could stand to lose a few pounds to lower our cardiovascular risk.

When the study came out in the European Heart Journal on March 16, Stamatina Iliodromiti, MD, a clinical lecturer in obstetrics and gynecology at the University of Glasgow in Scotland and the study’s corresponding author, told HealthDay: “The higher total body fat or fat around the abdomen, the greater the risk of heart disease and stroke in individuals without existing disease. There is no protective effect of fat, as some people believe.”

David Katz, director of the Yale-Griffin Prevention Research Center in Derby, Conn., was not part of the study team, but he gave HealthDay a pithy quote: “There is a limit to how many nails should be required to seal the coffin of the obesity paradox.”

The study covered the period between 2006 and 2010 and included people ages 40 to 69. Follow-up included hospitalization and death data up to August 2015 from England and Wales and June 2015 for Scotland.

People with a BMI between 22 and 23 had the lowest risk of heart disease and stroke, researchers found. Waist size also figured into people’s risk, consistent with findings that metabolically active abdominal fat has a causal role in cardiovascular disease.

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