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Can Heavier People Really Be Healthier?

Scientists call it the obesity paradox, the notion that being overweight or moderately obese lowers the risk of an early death. The phenomenon has been documented in large population studies and in groups of patients with chronic diseases like hypertension and Type 2 diabetes.

But a recently published article in The New England Journal of Medicine, is calling the obesity paradox into question, at least for patients with Type 2 diabetes.

The study, of nearly 12,000 people with the disease, found that there was no survival advantage for those who had a body mass index that put them in the overweight or obese categories. Instead, the researchers found that the diabetics with the lowest mortality rate were those who were considered normal weight.

The study is among the largest to examine the obesity paradox among people with Type 2 diabetes, an illness that afflicts more than 25 million Americans. The authors argue that previous studies showing a protective effect of a high B.M.I. among diabetics were flawed because they were too small or failed to account for factors like smoking or undiagnosed illnesses that can contribute to low body weight but a shorter life span as well.

The new study found that when smoking and other factors that can contribute to weight loss were accounted for, people in the highest B.M.I. groups had higher mortality rates.

"I think the case is not necessarily closed," said Deirdre K. Tobias, the lead author of the paper and a research fellow at the Harvard School of Public Health. “But at this point, there is no reason to believe that being overweight or obese would be protective for people with diabetes.”

“The recommendation is to do weight bearing exercises like walking and resistance training,” she said. “Because in addition to increasing aerobic capacity, it increases muscle mass, and that improves glucose control.”

Courtesy : Anahad O'Connor

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