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Updated: May 30, 2026
05:10
Multidisciplinary Approach to Obesity Management: A Case Report
Published on: May 30, 2025
The obesity paradox and weight loss
Jonathan Myers1, Kusum Lata, Shilpy Chowdhury
1Division of Cardiology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA. drj993@aol.com
The American Journal of Medicine
|July 30, 2011
Summary
Weight loss increased mortality risk, while weight gain lowered it, challenging the obesity paradox. This suggests disease-related weight loss and weight gain may influence cardiovascular outcomes.
Area of Science:
- Cardiology
- Metabolic Health
- Epidemiology
Background:
- The obesity paradox suggests better outcomes for overweight/obese individuals with cardiovascular disease.
- The impact of weight changes on this paradox and health outcomes remains unclear.
Purpose of the Study:
- To investigate the association between weight changes and mortality in men with established cardiovascular disease.
- To explore the role of weight fluctuations in the context of the obesity paradox.
Main Methods:
- Weight was measured in 3834 men at baseline and a mean of 7 years later.
- Cox proportional hazards analysis assessed associations between weight changes, fitness, risk markers, and mortality.
Main Results:
- Weight loss was linked to a 4% annual increase in mortality per pound lost (P<.001).
- Weight gain was associated with a 36% reduction in all-cause mortality (RR 0.64).
- Weight loss was associated with a 49% increase in all-cause mortality (RR 1.49), with higher cancer and cardiovascular death rates.
Conclusions:
- Weight loss correlates with increased mortality, while weight gain correlates with decreased mortality.
- The obesity paradox may be partly explained by non-volitional weight loss due to illness and a protective effect of weight gain.
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