The Obesity Paradox in the Elderly: Potential Mechanisms and Clinical Implications
Open accessAbstract
The prevalence of overweight and obesity in the elderly has become a growing concern. Recent evidence indicates that in the elderly, obesity is paradoxically associated with a lower, not higher, mortality risk. Although obesity in the general adult population is associated with higher mortality, this relationship is unclear for persons of advanced age and has lead to great controversy regarding the relationship between obesity and mortality in the elderly, the definition of obesity in the elderly, and the need for its treatment in this population. This article examines the evidence on these controversial issues, explores potential explanations for these findings, discusses the clinical implications, and provides recommendations for further research in this area.
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A paradoxical survival advantage with higher BMI exists in the elderly and in a broad range of illnesses, including diabetes mellitus, chronic heart failure, acute heart failure, coronary artery disease, and percutaneous coronary artery interventions.
“the case is strong that such a paradoxical relation exists in the elderly, 7 and accompanying a broad range of illnesses, including diabetes mellitus, 8 chronic heart failure, 9,10 acute heart failure, 11 coronary artery disease, 12 and percutaneous coronary artery interventions.13”
From Obesity Paradox in Hypertension: Is This Because Sympathetic Activation in Obesity-Hypertension Takes a Benign Form? (2018) · cites this paper as [7]
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- Authors
- Oreopoulos, A., Kalantar-Zadeh, K., Sharma, A. M., & Fonarow, G. C.
- Affiliations
- University of Alberta (CA)
- University of California, Los Angeles (US)
- Corresponding author
- Oreopoulos, Antigone
- Venue
- Clinics in Geriatric Medicine
- Publisher
- Elsevier BV
- Published
- 2009-11
- Volume
- 25
- Issue
- 4
- Pages
- 643-659
- ISSN
- 0749-0690 (ISSN-L)
- OpenAlex
- W1997453905
- Cited by
- 323
- References
- 114
- Citations by year
- 2026: 10 · 2025: 9 · 2024: 23 · 2023: 12 · 2022: 25 · 2021: 26 · 2020: 26 · 2019: 12 · 2018: 13 · 2017: 19 · 2016: 33 · 2015: 20 · 2014: 23 · 2013: 21 · 2012: 23
- FWCI
- 1.87
- Type
- journal article
- Language
- en
- Open access
- green
- escholarship.org
- Licence
- Locations
- Clinics in Geriatric Medicine (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Keywords
- obesity paradox, older adults, obesity, mortality risk, overweight, obesity definition, obesity treatment
- MeSH terms
- Activities of Daily Living, Adult, Age Factors, Aged, Aged, 80 and over, Cardiovascular Diseases, Cause of Death, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Nutrition Surveys, Obesity, Physical Fitness, Quality of Life, Risk, Sex Factors, Weight Loss, Body Mass Index, Survival Rate
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