Being overweight can’t protect you against illness. One professor believes the so-called “obesity paradox” may be a result of statistical methodology.
Bård Eirik Kulseng is critical of the conclusions in the Gemini article “More important to be active than thin for heart patients” and warns against inferring too much from this study. Kulseng is a professor in NTNU’s Department of Clinical and Molecular Medicine and heads the Centre for Obesity Research at St. Olavs Hospital in Trondheim.
Extra kilos are no help
The so-called “obesity paradox” is that a few extra kilos of body weight may increase your chances of survival if you get sick. Overweight individuals apparently survive strokes at a higher rate than people of normal weight, according to the disputed study.
“The article confirms that physical activity can protect against cardiovascular disease. The study also points out that exercising reduces the risks of obesity. Previous studies have shown that physical activity also provides psychosocial benefits. How the body manages our weight, food intake, activity, metabolism and psyche is a very complicated process. It’s going too far to say that everything will be fine just by exercising,” says Kulseng.
The professor says the obesity epidemic is a myth and controversial at best.
“I think the obesity paradox came about because of the way data and statistics are used,” says Kulseng. He points to an article in Annals of Epidemiology from May 2015 that shows that a skewed selection of statistical analyses is the probable explanation for the obesity paradox.
Along these lines, there is no reason for heart patients to weigh more than healthy individuals. Obesity is a strain on the body by any measure.
Advice for overweight individuals
So what should an overweight heart patient do?
“There is no general answer to this question. If you find yourself gaining weight, you should schedule a medical exam. Weight gain can result from medications, disease, stress or other conditions. What’s important is that weight gain is taken seriously and that you try to determine the cause. Not everyone who is overweight should lose weight. For a lot of people, the most important thing is to stop weight gain. A doctor has to consider patients as individuals – you can’t treat them all the same way,” says Kulseng.
In response to the question as to whether clinicians are effective enough at emphasizing the importance of physical activity for heart patients, Kulseng says:
“We clearly know that physical activity is good, but I wouldn’t do away with the bathroom scale. Nor do we recommend that normal weight patients lose weight.”