Commentary

The obesity paradox continues


 

AT THE ESC CONGRESS 2013

AMSTERDAM – Four studies presented at the European Society of Cardiology further highlighted the fact that there’s still much to be learned about the connection between obesity and its health risks. Data on the "obesity paradox" is building, and the usefulness of the body mass index continues to draw controversy.

A study by Danish researchers showed that obesity might not be all that bad if the overweight woman is metabolically healthy. "But because obesity markedly increases the risk of developing these metabolic disorders, these women most likely have a window of opportunity to lose weight and change their prognosis," said Dr. Michelle Schmiegelow of Gentofte Hospital, Hellerup, Denmark, in a statement.

Japanese researchers found that as the BMI increased, the risk of cardiovascular disease decreased among Japanese patients who had hypertension and were glucose intolerant. Still, the authors wrote, "Hypertensive patients with glucose intolerance and a high BMI should lose weight and restore their BMI to normal range."

Also, Dr. Aziza Azimi of Gentofte Hospital showed that weight maintenance or weight loss seemed to increase the risk of death in underweight women with coronary artery disease. "These data appear to be against the common sense that obesity is a risk factor for cardiovascular mortality, as underweight has been even more strongly related to worse clinical outcomes than overweight," she said in a statement. "Future investigations will be necessary to prove this new concept."

Meanwhile, long-term data from the French FAST-MI 2005 registry showed that both lean patients (BMI less than 22 kg/m2) and very obese patients (BMI of at least 35 kg/m2) had an increased risk of death at 5 years. "It is not good to be too lean or too fat, but it is worse still when you have a big belly," said Prof. Tabassome Simon of Hospital St. Antoine, Paris, France, in a statement.

To put the findings into perspective, we spoke with Prof. Diethelm Tschoepe of Germany, who moderated the session.

nmiller@frontlinemedcom.com

On Twitter @NaseemSMiller

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