Obesity Paradox” Debunked in New Research

 

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New research published in the European Heart Journal has debunked the “obesity paradox,” which suggested that overweight or obese heart failure patients had a lower risk of hospitalization or death compared to those with normal weight. The study found that using waist-to-height ratio measurements instead of body mass index (BMI) eliminates the perceived survival advantage for individuals with a BMI of 25kg/m² or more.

Study shows ‘obesity paradox’ does not exist: waist-to-height ratio is a better indicator of outcomes in patients with heart failure than BMI.

New research has debunked the idea that there is an “obesity paradox,” whereby patients with heart failure who are overweight or obese are thought to be less likely to end up in the hospital or die than people of normal weight.

The study, which was published in the European Heart Journal^[1] on March 22, shows that if doctors measure the ratio of waist to height of their patients, rather than looking at their body mass index (BMI), the supposed survival advantage for people with a BMI of 25kg/m² or more disappears.

The “obesity paradox” relates to counter-intuitive findings suggesting that, although people are at greater risk of developing heart problems if they are overweight or obese, once a person has developed a heart condition, those with higher BMIs appeared to do better and were less likely to die than those of normal weight. Various explanations have been suggested, including the fact that once someone has developed heart problems, some extra fat is somehow protective against further health problems and death, especially as people who develop a severe and chronic illness often lose weight.

John McMurray, Professor of Medical Cardiology at the University of Glasgow (UK), who led the latest research, said: “It has been suggested that living with obesity is a good thing for patients with heart failure and reduced ejection fraction – which is when the main chamber of the heart is unable to squeeze out the normal amounts of blood. We knew this could not be correct and that obesity must be bad rather than good. We reckoned that part of the problem was that BMI was a weak indicator of how much fatty tissue a patient has.”