Obesity paradox is that people with established cardiovascular diseases including hypertension, heart failure, coronary artery disease and peripheral arterial disease, have better prognosis if they are overweight or obese .
Four obesity related paradoxes have been listed:
- Classic obesity paradox: obesity is protective in chronic disease states
- Preobesity paradox: overweight is protective in normal populations
- Fat-but-fit concept: obesity is not a risk factor for mortality in fit individuals
- Metabolically healthy obesity: phenotype associated with younger age, higher levels of physical activity, better nutritional quality and low levels of visceral adipose tissue
This does not mean that obesity is a negative risk factor for cardiovascular disease. Obesity has an important causal role in insulin resistance, metabolic syndrome, type 2 diabetes mellitus, hypertension, dyslipidemia, abnormal left ventricular geometry, endothelial dysfunction and heart failure. Obesity can predispose to coronary artery disease, obstructive sleep apnea and atrial fibrillation.
- Lavie CJ, Milani RV, Ventura HO. Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss. J Am Coll Cardiol. 2009 May 26;53(21):1925-32.