The obesity paradox: an endocrine perspective

Area of Science:

• Endocrinology
• Metabolic Disorders
• Cardiovascular Health

Background:

• Obesity is a global epidemic linked to cardiovascular risks like type 2 diabetes mellitus, hypertension, and lipid disorders.
• Paradoxically, some studies indicate a survival advantage in overweight/obese individuals with chronic diseases compared to normal-weight individuals.
• The obesity paradox is gaining interest in chronic endocrine disorders, including osteoporosis, type 2 diabetes mellitus, chronic kidney disease, and coronary artery disease.

Purpose of the Study:

• To review postulated mechanisms and current evidence of the obesity paradox.
• To focus on the obesity paradox within endocrine-related diseases.
• To discuss confounding factors and biases in observational studies reporting the paradox.

Main Methods:

• Literature review of observational studies and scientific evidence.
• Analysis of postulated mechanisms underlying the obesity paradox.
• Examination of confounding factors and biases in existing research.

Main Results:

• Observational studies suggest a potential survival advantage for some overweight/obese individuals with chronic endocrine diseases.
• The paradox is noted in conditions such as osteoporosis, type 2 diabetes mellitus, chronic kidney disease, and coronary artery disease.
• Confounders and biases significantly influence the interpretation of these observational findings.

Conclusions:

• Despite the observed obesity paradox in certain chronic endocrine conditions, substantial evidence supports the benefits of weight reduction.
• Further research is needed to elucidate the mechanisms and confirm the validity of the obesity paradox, accounting for biases.
• Weight management remains crucial for overall health outcomes, even in the context of the obesity paradox.