A study published in 2013 in the Journal of Obesity Epidemiology reported that there may be an obesity paradox.1 Meaning that there is an inverse association of patients that were overweight with increased mortality and no increased incidence of mortality in patients with class I obesity (BMI 30.0-34.9 kg/m2). Was this really true? Could excess weight be protective against mortality and even lower it?
A recent study in 2017 was conducted to test the validity of the study reported above. This study was set up to look at the relationship between the maximum BMI over 16 years and subsequent mortality incidence.2 Before this study was performed it was necessary to come up with possible explanations for the results found in the 2013 study. The first explanation for the surprising findings was that when patients become sick; especially at the end of their life, there is a well-documented loss of weight. The weight at which a person dies, is often not the weight at which they lived with in the recent past. Therefore, patients that were class II obesity before they became sick or class I obesity before they became sick but lost weight just prior to their death can drastically affect these results. Another reason is that confounding factors were not effectively removed prior to collecting the data for the study. Confounding factors include anything that could affect the researchers to come to the true conclusion for their study. The easiest confounding factor to tease out is smoking as smoking has a weight protective effect. Smoking increases hormone sensitive lipase (HSL) which increases the lipolytic pathways (fat burning) in the body.
The 2017 study evaluated 225,072 men and women with 32,571 deaths overserved during the time the study was being conducted. The findings from this study found that the lowest risk for death was between a BMI of 18.5 to 24.9 kg/m2, known as normal weight regardless of smoking status. Maximum BMIs in the overweight and obese categories were associated with elevated risks for all-cause deaths. The use of maximum BMIs with an extended weight history period minimize the reverse causation notion noted in the 2013 study. Maximum BMIs with weight history have eliminated the obesity paradox.
The destination for weight loss is The Metabolism Clinic as we recognize that excess fat on the body is significantly detrimental to the health of the patient.
The Metabolism Clinic is established as the destination for weight loss and reversal of diabetes. Based in Charlotte, North Carolina. www.themetabolismclinic.com