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Obesity paradox: A big belly can be lethal

By FnF Desk | PUBLISHED: 02, Sep 2013, 13:40 pm IST | UPDATED: 02, Sep 2013, 13:49 pm IST

Obesity paradox: A big belly can be lethal A new study has found that a big waist and severe obesity is highly linked to fatality in heart attack survivors. Professor Tabassome Simon said that the impact of obesity on long term mortality and cardiovascular complications in the general population has been the object of recent debate and much emphasis has also been given to the deleterious role of abdominal obesity.

Simon said that at the time of a heart attack, early mortality tends to be lower in obese patients, a phenomenon well known in critical care situations and described as the ‘obesity paradox’.

At 5 years, absolute mortality was highest in the leanest patients (BMI less than 22 kg/m2) and lowest in patients with BMI between 25 and 35 kg/m2 (i.e. overweight and mild obesity). Patients with severe obesity (BMI = 35 kg/m2) had a markedly increased mortality after 3 years. Severe abdominal obesity (waist circumference more than 100 cm in women and more than 115 cm in men) was also associated with increased long-term mortality.

Simon said that as waist circumference is strongly linked to BMI, the researchers determined the upper quartile of waist circumference within each BMI category and used both variables together to determine their respective role in association with long-term mortality.

She added that they found that both lean patients (BMI less than 22 kg/m2) and very obese patients (BMI =35 kg/m2) had an increased risk of death at 5 years: + 41 percent and + 65 percent, respectively. Being in the upper quartile of waist circumference was also an indicator of increased mortality at 5 years (+ 44 percent).

Diseases the obese need to watch out for:


Diabetes is a metabolic disease which is characterised by high blood sugar levels. It can be caused either due to the lack of insulin (type 1 diabetes) or because the body’s cells fail to respond to the insulin produced (type 2 diabetes). Some of the common symptoms of diabetes are hunger, frequent urination and increased thirst. While type 1 diabetes is usually genetic, type 2 diabetes is caused more by lifestyle factors. It is one of the common ‘lifestyle diseases’ which is plaguing people in the developed countries and often has a causal link to heart diseases, hypertension and obesity.

Cardiovascular disease

Heart disease or cardiovascular disease refers to a group of diseases that involve the heart and/ or blood vessels. Some of the more common ones are coronary heart disease, hypertension, stroke and peripheral arterial disease. While susceptibility to heart diseases increases with age, gender, high blood pressure, high cholesterol levels, stress there are many things we can do to improve our cardiovascular health. A low fat, high fibre diet with fruits and veggies, quitting smoking and giving up alcohol coupled with increased physical activity and less stress can go a long way in improving cardiovascular health. 


Hypertension or high blood pressure is one of the most common lifestyle diseases. Blood flows through our arteries with pressure. This pressure is determined by the pumping of the heart as well as resistance to the flow of blood by the arteries. Due to genetics, high cholesterol or other reasons, the wall of the blood vessels get thickened leading to increased resistance for the blood to flow. This causes the blood pressure to go up causing hypertension. Elevated blood pressure is linked to a variety of diseases – coronary artery diseases, heart diseases, stroke, kidney diseases, vision loss and erectile dysfunction. High BP can be curtailed by exercising more, eating right, with antihypertensives and by keeping stress at bay.


Arthritis is a joint disorder that causes the inflammation of one or more joints. The pain is caused due to the inflammation around the joints. Some of the types of arthritis include osteoarthritis, rheumatoid arthritis, psoriatic arthritis, etc. Osteoarthritis is the most common form – caused due to overuse or injury – and can affect all joints. The other forms can either be genetic, caused due to skin conditions (psoriatic), immune disorder (rheumatoid) or by deposition of uric acid (gout). Almost 50 million people around the world are affected by one form or another.

Sleep apnoea

Sleep apnoea (apnea in American English) is a sleep disorder characterised by abnormal breathing. They can be classified as obstructive, central or mixed sleep apnoea. Obstructive sleep apnoea (OSA) is caused by a blockage in the airway and is usually characterised by snoring. Various studies have linked OSA to heart diseases, hypertension, stroke, diabetes, depression and obesity. On the other hand central sleep apnoea is usually characterised by low breathing which can indicate less blood flow. This leads to a drop in blood oxygen which causes seizures, angina, heart attacks and even death.