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Obesity paradox confirmed to exist in first meta-analysis

This is a diagram showing rates of obesity in United States by race.
This is a diagram showing rates of obesity in United States by race.
Deborah Cragun CDC Public domain as a work of the U. S. government.

People that are obese or overweight have a greater chance of surviving heart disease and heart attacks than people that have normal weight and people that would be considered too thin. This contradiction in expected outcome is called the obesity paradox. Dr. Abhishek Sharma, Cardiology Fellow at the State University of New York Downstate Medical Center in Brooklyn, New York and colleagues published the most comprehensive study of weight and heart disease ever conducted in the July 16, 2014, edition of the journal Mayo Clinic Proceedings.

The researchers analyzed data from 36 previous studies that examined weight and the incidence of cardiovascular disease and the survival rates of cardiovascular disease. The study found that obese and overweight people do have a lower risk of death from cardiovascular problems than people of normal weight and people that are considered too thin. The results may appear paradoxical but the data is considered to be firm evidence of the phenomena. The difference in death from heart disease was five percent.

The researchers assert that they do not know why the obesity paradox exists. Some evidence indicates that overweight and obese people take more statin drugs to prevent cholesterol build up in their arteries. More overweight and obese people also have higher metabolic reserves that could help them recover from a cardiovascular event versus thin people. A genetic predisposition toward less cardiac disease may also play a role in the obesity paradox.

A second study published in the same journal on the same day explains part of the obesity paradox based on body composition. Dr. Carl Lavie and colleagues from the University of Queensland School of Medicine found that the amount of skeletal muscle in a person’s body plays a significant role in surviving a cardiovascular event like a heart attack. This study also found that obesity confers some small advantage to survival of cardiovascular disease.

Both studies do not claim that being obese or overweight is good for any person’s health. The small protection that obesity provides from some cardiovascular disease in the short term is outweighed by the eventual problems caused by other complications like diabetes that are caused by obesity. Being obese or overweight for a long time is still considered a recipe for poor cardiovascular health and an early death.