Penn Medicine: Obesity/Mortality Paradox Demonstrates Urgent Need for More Refined Metabolic Measures

Researchers from the Perelman School of Medicine at the University of Pennsylvania point out that the body mass index (BMI), based on the weight and height, is not an accurate measure of body fat content and does not account for critical factors that contribute to health or mortality, such as fat distribution, proportion of muscle to fat, and the sex and racial differences in body composition.

Obesity predisposes to diabetes, heart diseases, sleep apnea, cancer and other diseases. Although several studies have shown an increase in mortality in obese people, recent studies have suggested that obesity protects against death from all causes as well as death due to chronic diseases such as diabetes, heart failure, and stroke. This so-called “obesity-mortality” paradox suggesting a beneficial influence of obesity has generated a lot of controversy.

In a new perspective article in the journal Science, Rexford Ahima, MD, PhD, Professor of Medicine and Director of the Obesity Unit in the Institute for Diabetes, Obesity and Metabolism, and Mitchell Lazar, MD, PhD, Professor of Medicine and Genetics and Director of the Institute of Diabetes, Obesity, and Metabolism, discuss the challenges of studying the health and mortality risks of obesity.

“There is an urgent need for accurate, practical and affordable tools to measure fat and skeletal muscle, and biomarkers that can better predict the risks of diseases and mortality,” said Dr. Ahima. “Advances to improve the measurement of obesity and related factors will help determine the optimal weight for an individual, taking into account factors such as age, sex, genetics, fitness, pre-existing diseases, as well novel blood markers and metabolic parameters altered by obesity.”

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