The Obesity Paradox: Does It Matter?

Sandra Adamson Fryhofer, MD


January 22, 2013

In This Article
Sandra Adamson Fryhofer, MD
Clinical Associate Professor of Medicine, Emory University School of Medicine, Atlanta, Georgia; Past President, American College of Physicians

Paradox and Obesity: A Clinician's Perspective

This edition of Staying Well considers the obesity paradox observed in several recent studies and how it fits into clinical practice. To paraphrase the dictionary definition, a paradox is a statement that seems contradictory and doesn't make sense, even if it is perhaps true.[1]

We know the numbers. Two thirds of adult Americans are overweight, with one third being obese.[2] We know the consequences of obesity: increased risk for high blood pressure, diabetes, heart disease, stroke, and kidney disease.[3]

It is not entirely clear why some studies[4,5,6,7] found that people with obesity-related consequences and who are carrying excess pounds have better outcomes, including less mortality in some cases, than their normal-weight peers. Many of these findings apply to people with diabetes, stroke, and acute coronary syndrome.