Журнал терапии ожирения и снижения веса

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Demystifying the Obesity Paradox in Acute Conditions and Injuries

Bowei Su, Sebastien Fuchs

Efficient lipid storage has been crucial to survival for much of human history; however, in the modern era, this trait has evolved into a rising obesity pandemic of great concern, with rates tripling since 1975. Obesity is a well-established pro-inflammatory process leading to diabetes, hypertension, heart disease, cancer, and other long-term sequelae. The detrimental effects of obesity are prevalent throughout literature. On the other hand, the question of any possible benefits yields less of a consensus. There has been growing evidence across multiple fields describing a phenomenon called the “Obesity Paradox”, which describes a possible mortality benefit with being overweight/obese in the setting of acute and chronic illness. We compiled studies investigating this phenomenon in relation to leading American causes of death, including heart disease, blunt trauma, cancer, and lung injury which are covered in this current snapshot. We examine common clinical and methodological themes between studies, and limitations of the implications inherent in study design and the body mass index metric. This review is meant to be a bird’s-eye overview of the ongoing debate surrounding this in several fields to facilitate discussion and propose directionality for future research to further elucidate the nuances of the complex relationships with obesity.