US Pharm. 2013;38(1):HS-18.
“Can overweight as defined by BMI
actually have a protective association with mortality?” ask Steven B.
Heymsfield, MD, and William T. Cefalu, MD, of the Pennington Biomedical
Research Center, Baton Rouge, Louisiana, in an editorial appearing in JAMA.
“The presence of a wasting disease,
heart disease, diabetes, renal dialysis, or older age are all
associated with an inverse relationship between BMI and mortality rate,
an observation termed the obesity paradox or reverse epidemiology,”
they write. “The optimal BMI linked with lowest mortality in patients
with chronic disease may be within the overweight and obesity range.
Even in the absence of chronic disease, small excess amounts of adipose
tissue may provide needed energy reserves during acute catabolic
illnesses, have beneficial mechanical effects with some types of
traumatic injuries, and convey other salutary effects that need to be
investigated in light of the studies by Flegal et al and others.”