The Health Risk of Obesity—Better Metrics Imperative

@article{Ahima2013TheHR,
  title={The Health Risk of Obesity—Better Metrics Imperative},
  author={Rexford S. Ahima and Mitchell A. Lazar},
  journal={Science},
  year={2013},
  volume={341},
  pages={856 - 858}
}
The impact of a high BMI on mortality is in question, calling for a rethinking of how metabolic health is assessed. Obesity has increased worldwide; is a major risk factor for diabetes, cardiovascular disease, cancer, sleep apnea, nonalcoholic fatty liver disease, osteoarthritis, and other ailments; and has been associated with disability, mortality, and enormous health costs (1, 2). Despite these clear adverse consequences of obesity, some studies have suggested that obesity as defined by body… 
View on AAAS
ncbi.nlm.nih.gov
315 Citations
Highly Influential Citations
18
Background Citations
117
Methods Citations
8
Results Citations
3

315 Citations

Obesity or obesities? Controversies on the association between body mass index and premature mortality

An introductory narrative overview of the origin and current use of the concepts of MHO, MONW and OP is presented, which appear as a consequence of the frail current diagnostic definition of obesity based only on BMI.

Obesities: Controversies in Diagnosis and Classification

Crucial areas of research are the interactions that link MHO, MONW, and OP with body composition, fat distribution, aging, and cardiorespiratory fitness.

Is the metabolically healthy obesity phenotype an irrelevant artifact for public health?

It is argued that the MHO phenotype is not benign and as such has very limited relevance as a public health target and more efforts must be allocated to reducing the distal and actual causal agents that lead to weight gain.

Metabolically healthy obesity: the low-hanging fruit in obesity treatment?

New anthropometric measurement alternatives to BMI and hypertension

Fat distribution plays an important role in the risk of diseases, such as hypertension and T2DM, and traditional anthropometric measures such as BMI and WC assess only obesity and are unable to distinguish between visceral and subcutaneous adipose tissue.

Body Shape Index — a Novel Premature Death Risk Factor

The article covers the topic of stratifying risk factors for premature death associated with cardiovascular disease, such as gender, age, smoking, dyslipidemia, fasting serum glucose levels, target…

Unravelling gender‐specific factors that link obesity to albuminuria

The aim of this study was to evaluate the gender‐dependent differences in the development of early obesity‐related disease, focusing on pathologic microalbuminuria (PMA).

Body mass index versus surrogate measures of central adiposity as independent predictors of mortality in type 2 diabetes

An “overweight paradox” remained after controlling for age, smoking, and comorbidities, arguing against a collider bias or reverse causation, however, it could be partly explained by confounding from PA level, possibly through its impact on lean mass and cardiorespiratory fitness.

Causes, Characteristics, and Consequences of Metabolically Unhealthy Normal Weight in Humans.

Pathways linking obesity to health-related quality of life

Obesity was negatively associated with HRQOL through obesity-related diseases in both genders, and in men, the positive association between obesity and SRH resulted in a non-significant association of obesity withHRQOL.
...

References

SHOWING 1-10 OF 21 REFERENCES

Obesity paradox: differential effects on cancer and noncancer mortality in patients with type 2 diabetes mellitus.

Physical activity, fitness and fatness: relations to mortality, morbidity and disease risk factors. A systematic review

  • M. Fogelholm
  • Medicine
    Obesity reviews : an official journal of the International Association for the Study of Obesity
  • 2010
Having high BMI even with high physical activity was a greater risk for the incidence of type 2 diabetes and the prevalence of cardiovascular and diabetes risk factors, compared with normal BMI with low physical activity.

A New Body Shape Index Predicts Mortality Hazard Independently of Body Mass Index

Body shape, as measured by ABSI, appears to be a substantial risk factor for premature mortality in the general population derivable from basic clinical measurements.

Body mass index and mortality in heart failure: a meta-analysis.

Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes.

An intensive lifestyle intervention focusing on weight loss did not reduce the rate of cardiovascular events in overweight or obese adults with type 2 diabetes.

Association of weight status with mortality in adults with incident diabetes.

CONTEXT Type 2 diabetes in normal-weight adults (body mass index [BMI] <25) is a representation of the metabolically obese normal-weight phenotype with unknown mortality consequences. OBJECTIVE To…

Body-mass index and mortality among 1.46 million white adults.

In white adults, overweight and obesity (and possibly underweight) are associated with increased all-cause mortality and the hazard ratios for the men were similar.

Body Mass Index and Diabetes in Asia: A Cross-Sectional Pooled Analysis of 900,000 Individuals in the Asia Cohort Consortium

The positive association between BMI and diabetes prevalence was present in all cohorts and in all subgroups of the study population, although the association was stronger in individuals below age 50 at baseline.

BMI–Mortality Paradox and Fitness in African American and Caucasian Men With Type 2 Diabetes

A paradoxic BMI–mortality risk association was observed in African American and Caucasian patients with diabetes and was more potent in those with a BMI ≥25 kg/m2.

The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999-2004).

There is a high prevalence of clustering of cardiometabolic abnormalities among normal-weight individuals and ahigh prevalence of overweight and obese individuals who are metabolically healthy among US adults.