What You Need To Know About the Obesity Paradox


It has been widely accepted that being obese can lead to all sorts of health complications. However, in recent times there’s increasing data suggesting body fat may, in some cases, impart a kind of protective benefit. This has led to what’s known as the “obesity paradox”—the fact that moderately obese people with chronic diseases are often outliving normal-weight people with the same health issues.

How can this be, you may ask? This seems to be how it works– “Someone who is obese or overweight is at a higher risk for developing something like heart disease or diabetes,” explains Rebecca Shenkman, MPH, RDN, LDN, director of the MacDonald Center for Obesity Prevention and Education at Villanova University. “However, once they have the disease, then being in an overweight category seems to offer some protective effect.” The obesity paradox doesn’t mean we all have free rein to gain weight without worrying about our health; it means once you’re already sick, carrying around a few extra pounds might do some good.

If you have brittle bones, the obesity paradox may also work for you. The same estrogen produced by body fat protects against bone loss. Overweight or even obese women have a lower risk for osteoporosis than thin, small-framed women do. Having a BMI of 30 has been linked to around 8% greater bone mineral density (a measure of bone strength) in the spine and hip regions, compared with having a BMI of 20. Physically carrying additional pounds is not unlike doing weight-bearing exercises, also known as a skeleton’s best friend.

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Also, weight’s role in breast cancer risk changes over time. Before menopause, some studies show a reduced risk of breast cancer among overweight/obese women. But after menopause, the extra weight is known to increase that same risk. “Compared to women of a normal weight, a 5-point increase in BMI corresponded to 17% lower risk of premenopausal breast cancer,” explains Louise Brinton, PhD, MPH, chief of the National Cancer Institute’s Hormonal and Reproductive Epidemiology Branch. This is probably due to their level of estrogen, she says, which is intricately involved in breast cancer. Obesity before menopause may skew a woman’s hormonal balance in a way that leads to cycles that do not release an egg. No egg means less estrogen, or less fuel for breast cancer to grow. But body fat also produces its own estrogen, and after menopause, excess fat may lead to more estrogen-responsive tumors among overweight women.

However, please not that this is not an encouragement to gain needless weight. The obesity paradox, is merely a silver lining for those who are already ill and obese. It is not a license to binge!

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