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The idea that it might be possible to be overweight or obese but not at increased risk of heart disease, otherwise known as the "obesity paradox," has been challenged by a study of nearly 300,000 people published in in the European Heart Journal today (Friday).
This latest research shows that the risk of heart and blood vessel problems, such as heart attacks, strokes and high blood pressure, increases as body mass index (BMI) increases beyond a BMI of 22-23 kg/m2. Furthermore, the risk also increases steadily the more fat a person carries around their waist.
[...] Although it is already known that being overweight or obese increases a person's risk of CVD [cardiovascular disease], as well as other diseases such as cancer, there have also been studies that have suggested that, particularly in the elderly, being overweight or even obese might not have any effect on deaths from CVD or other causes, and may even be protective, especially if people maintain a reasonable level of fitness. This is known as the "obesity paradox."
However, the authors of the EHJ study say their results refute these previous, conflicting findings. "Any public misconception of a potential 'protective' effect of fat on heart and stroke risks should be challenged," said Dr Iliodromiti.
She continued: "This is the largest study that provides evidence against the obesity paradox in healthy people. It is possible that the story may be different for those with pre-existing disease because there is evidence that in cancer patients, for instance, being slightly overweight is associated with lower risk, especially as cancer and its treatments can lead to unhealthy weight loss.
[...] The researchers suggest that the previous confusion over the "obesity paradox" may be due to many factors that can confound results of studies. For instance, smoking changes the distribution of fat in the body, smokers may have lower weight as smoking depresses appetites and so BMI tends to be lower. Another reason could be that some people have existing but undiagnosed disease, which can often lower their weight but also makes them more likely to die prematurely.
(Score: 1, Informative) by Anonymous Coward on Sunday March 18 2018, @03:20PM
The BMI is completely valid when used on a population at large. The number of false positives is generally balanced against the false negatives.
Where it has issues is when it's used as a determiner for an individual's obesity as it fails to include things like muscle mass, frame size, proportion or physical fitness in any direct way. It's a perfectly fine measurement for using on the population at large, but it fails miserably and predictably when used on individuals. But, it's simple and relatively hard to get wrong and it's been around long enough that researchers can use it to compare against older studies to see if there's been any general trends going on.
If you're trying to figure out if you personally are obese, either measuring the body composition or just taking the hip to waist ratio is probably a better choice, but those are too complicated for use in large statistical analyses.