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Cited by 698

The DOI matches its Crossref record; 27 of the 27 references it cites were found in a registry or an index.

An Overview and Update on Obesity and the Obesity Paradox in Cardiovascular Diseases

Elagizi, Andrew, Kachur, Sergey, Lavie, Carl J., Carbone, Salvatore, Pandey, Ambarish, Ortega, Francisco B., Milani, Richard V.·2018·Progress in Cardiovascular Diseases
DOI 10.1016/j.pcad.2018.07.003
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Abstract

Obesity increases a number of cardiovascular disease (CVD) risk factors, but patients with many types of CVD may have a better prognosis if classified as overweight or obese, a phenomenon known as the "obesity paradox". This paradoxical benefit of a medically unfavorable phenotype is particularly strong in the overweight and class I obesity, and less pronounced in the more severe or morbidly obese populations (class II-III and greater). Rather than an obesity paradox, it is possible that this phenomenon may represent a "lean paradox", in which individuals classified as normal weight or underweight may have a poorer prognosis with respect to CVD, as a result of a progressive catabolic state and lean mass loss. Cardiorespiratory fitness (CRF) is a fundamental part of this discussion. A greater CRF is associated with lower CVD risk, regardless of body mass index (BMI). Also, the assessment of body composition compartments (i.e., fat mass, fat-free mass, lean mass) and the presence of metabolic derangements may be better indicators of CVD risk than BMI alone. The focus of this review is to summarize the current evidence of the obesity paradox. Moreover, we discuss the utility and limitations of BMI for cardiometabolic risk stratification, in addition to concepts such as "metabolically healthy obesity" (MHO) and the "fat but fit" phenomenon, which describe patients who are diagnosed with obesity using BMI, but without major metabolic derangements and with greater CRF, respectively. Finally, we propose that obese patients presenting with an excess body fat, yet without metabolic abnormalities, should still be viewed as an "at risk" population, and as such should receive advice to change their lifestyle to improve their CRF and to prevent the development of impaired fasting glucose, diabetes mellitus and other CVD risk factors as a form of primary prevention.

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Metadata

Authors
Elagizi, A., Kachur, S., Lavie, C. J., Carbone, S., Pandey, A., Ortega, F. B., & Milani, R. V.
Venue
Progress in Cardiovascular Diseases
Publisher
Elsevier BV
Published
2018-07
Volume
61
Issue
2
Pages
142-150
ISSN
0033-0620 (ISSN-L)
DOI
10.1016/j.pcad.2018.07.003
OpenAlex
W2812742579
Cited by
698
References
27
FWCI
45.54
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: An Overview and Update on Obesity and the Obesity Paradox in Cardiovascular Diseases. https://app.cochat.ai/papers/10.1016/j.pcad.2018.07.003
The paper
Elagizi, A., Kachur, S., Lavie, C. J., Carbone, S., Pandey, A., Ortega, F. B., & Milani, R. V. (2018). An Overview and Update on Obesity and the Obesity Paradox in Cardiovascular Diseases. Progress in Cardiovascular Diseases. https://doi.org/10.1016/j.pcad.2018.07.003

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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.