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Medical The Obesity Paradox

  1. Sep 19, 2012 #1
    And quite a paradox it is. Goes against everything we have been taught:

  2. jcsd
  3. Sep 19, 2012 #2


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  4. Sep 19, 2012 #3
    The "paradox" does not seem so paradoxical. For example, if a thin person has type 2 diabetes then it might be because he has some bizarre severe underlying problem--normally thin people do not get type 2 diabetes. Indeed the person mght have some partial type 1 diabetes (or may have simply been misdiagnosed as having type 2). While type 2 is commonly thought to be insulin resistance, there is actually often a component of low insulin production, the hallmark of type 1.

    Type 1 diabetes is positively associated with thinness (not because thinness is intrinsically causing it, but rather because type 1 causes wasting) and is more serious than type 2.
  5. Sep 19, 2012 #4


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    That was just a brief mention in the first two paragraphs, the article itself mentions a dozen different studies and is probably best summed up here
    The article isn't about diabetes either, it's about all diseases previously considered to be "obesity related".

    Since the article is a hodgepodge of "this and that", you have to read the entire article to get the "gist".
  6. Sep 19, 2012 #5
    Several different doctors from different fields of medicine are quoted in the article. The "paradox" ranges over a wide list of diseases. Dr. Carl Lavie is cited as "one of the first researchers to document the obesity paradox, among patients with heart failure in 2002." He's quoted the most in the article, so I suspect, if I had to guess, the author had the most contact with him, that he prompted the article.
  7. Sep 19, 2012 #6
    Yes, the "gist" seems to be that, under stress of disease, fat people fare much better than thin people, which goes against expectation.
  8. Sep 19, 2012 #7
    Most of the diseases associated with obesity are in some way connected with diabetes. For example, the article mentions kidney disease. Diabetes is a major risk factor for kidney disease. It also is a major risk factor for high blood pressure which is also a major risk factor for kidney disease.

    One way we can pretty much know that it is the diabetes (and pre-diabetes) that is causing the obesity related diseases is that people who are obese but have their excess weight on their lower body are not at increased risk of diabetes...and turn out not to be at increased risk for heart disease either. That is quite a coincidence.

    And even forgetting the diabetes connection, the same general principle I gave for diabetes likely applies elsewhere. For example, a person with 160/100 blood pressure who is not overweight might very well need to be pretty sick to have that high a pressure, while an obese person with that same blood pressure might have little else4 wrong with him except things relating to obesity.

    An interesting thing in your article, and one that is quite true, is that very thin people have a much higher death rate than slightly obese people, and that slighly overweight people have the lowest death rates.
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