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By Mark Faries, PhD

De Gonzalez AB, Hartge P, Cerhan JR, et al. Body-Mass Index and Mortality among 1.46 Million White Adults. The New England journal of medicine. 2010;363(23):2211-2219. doi:10.1056/NEJMoa1000367.

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Howdy, I'm Dr. Mark Faries and I am dedicated to separating fact from fiction regarding topics of exercise and healthful eating.

I have come across a proposition that being obese actually has a protective effect in diabetics. But, is this fact or fiction?

A recent article by a prestigious group of researchers has provided some solid evidence regarding the idea of what’s called the "obesity paradox." Marilynn Marchione, the Associated Press’ chief medical writer, covered this research in her own lay article. I thought I’d share an excerpt to address the obesity paradox.

Marchione says, “The obesity paradox or the controversial notion that being overweight might actually be healthier for some people with diabetes seems to be a myth, according to researchers. A major study finds there's no survival advantage to being large, and a disadvantage to being very large.”

She continues by saying, “More than 24 million Americans have diabetes, mostly Type 2, the kind that is on the rise because of obesity. About two-thirds of U.S. adults are overweight, including one-third who are obese. Weighing too much increases the chances of heart disease, cancer and premature death. But some small studies have suggested this might not be true for everyone, and that Type 2 diabetics might even benefit from a few extra pounds by serving as a ‘metabolic reserve’ to help get them through sickness.”

Marchione says, “The new research—which looked at deaths according to how much people weighed when they were diagnosed with diabetes—dispels that idea. ‘We did not see this protective effect at all,’ said one study leader, Diedre Tobias of the Harvard School of Public Health. ‘The lowest risk was seen in the normal-weight category.’ The National Institutes of Health and the American Diabetes Association paid for the work. Results are in this issue of the New England Journal of Medicine.”

“…`It's a very convincing study’ and large enough to give a clear answer", said an independent expert, Dr. Patrick Remington, associate dean for public health at the University of Wisconsin-Madison.

The lowest risk was among those in the normal range. For the rest, researchers saw a J-shaped curve—deaths trended higher at both extremes. Being just a little overweight did not substantially raise the risk of death, but the trend was in that direction.”

The study was big enough that researchers could look at subgroups. For those under 65 when they were diagnosed with diabetes, the risk of death rose directly in relation to BMI.

So the claim that weight boosts survival for diabetics is fiction.

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