On the trail of the obesity paradox

Abstract

The obesity paradox refers to the phenomenon that overweight or obesity in patients with diseases, for which obesity and its metabolic sequelae constitute risk factors, may be protective and hence associated with decreased mortality. Gruberg et al. (1) observed that overall mortality was significantly higher in patients with coronary artery disease after percutaneous coronary intervention and normal body mass index (BMI) compared to overweight subjects. Since then, a number of studies, often encompassed by the term "reverse epidemiology", found that obesity or overweight, mostly defined by BMI, were associated with