Obesity Paradox: Why Being Overweight Might Not Matter as Much as You Think


Health effects of excess weight and how new research is showing that carrying extra weight may not be as bad as once believed. The Obesity Paradox is a term used to describe that being fat and fit may be healthier than skinny and unfit due to the fact that extra fat may protect the body.

More than one third of U.S. adults are obese. And being overweight or obese can put people at a greater risk for other health complications like heart disease and diabetes. Yet, in the last decade or so, there’s increasing data suggesting body fat may, in some cases, impart a kind of protective benefit. This has led to what’s known as the “obesity paradox”—the fact that moderately obese people with chronic diseases are often outliving normal-weight people with the same health issues.

“Body composition plays a critical role in the obesity paradox,” said Carl Lavie, a cardiologist at the University of Queensland School of Medicine in New Orleans and a co-author of both papers. He and his colleagues examined something called the lean mass index — the proportion of human stuff, like muscle and bone, that isn’t body fat — among 48,000 patients.

Their findings yield more evidence for what many have suspected. “At higher BMI, body fat is associated with an increase in mortality,” Lavie said. In other words, the fat isn’t the elixir; being big is. “Whenever examining a potential protective effect of body fat, lean mass index — which likely represents larger skeletal muscle mass — should be considered,”

Whatever the explanation for the obesity paradox turns out to be, most experts agree that the data cast an uncertain light on the role of body fat. “Maintaining fitness is good and maintaining low weight is good,” Dr. Lavie said. “But if you had to go off one, it looks like it’s more important to maintain your fitness than your leanness. Fitness looks a little bit more protective.”

That is a message that may take a long time to reach your family physician, however. “Paradigm shifts take time,” Ms. Bacon said. “They also take courage. Not many people are willing to challenge the weight conventions. They’re just too culturally embedded, and the risk of going against convention is too high.”






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