The DOI matches its Crossref record; 82 of the 83 references it cites were found in a registry or an index.
Healthy obese versus unhealthy lean: the obesity paradox
Abstract
Overweight and obesity have reached epidemic proportions in the USA and most of the rest of the world. Particularly concerning is the very high prevalence of class III obesity (BMI ≥40 kg/m(2)), which has reached ∼3% in the USA. In the past few years, controversy has surrounded the idea that some individuals with obesity can be considered healthy with regards to their metabolic and cardiorespiratory fitness, which has been termed the 'obesity paradox'. These controversies are reviewed in detail here, including discussion of the very favourable prognosis in patients with obesity who have no notable metabolic abnormalities and who have preserved fitness. The article also discusses the suggestion that greater emphasis should be placed on improving fitness rather than weight loss per se in the primary and secondary prevention of cardiovascular diseases, at least in patients with overweight and class I obesity (BMI 30-35 kg/m(2)).
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“The “obesity paradox”, which suggest a positive association between increasing BMI as it pertains to a specific disease, was firstly reported in heart failure31, but has since been described in a variety of disease processes, including other gynecologic cancers32–34.”
From Gut microbiome diversity is an independent predictor of survival in cervical cancer patients receiving chemoradiation (2021) · cites this paper as [32]
Citations
Cites
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Systematic review and meta-analysis
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Obesity and Cardiovascular Disease
Lavie, C. J., Milani, R. V., & Ventura, H. O. (2009) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2008.12.068 · Cited by 2,326
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1 of the 83 references couldn’t be matched to a known paper.
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The metabolic phenotype in obesity: Fat mass, body fat distribution, and adipose tissue function
Goossens, G. H. (2017) · Obesity Facts · doi:10.1159/000471488 · Cited by 8,481
Obesity Phenotypes, Diabetes, and Cardiovascular Diseases
Piché, M., Tchernof, A., & Després, J. (2020) · Circulation Research · doi:10.1161/circresaha.120.316101 · Cited by 2,133
Obesity and Cardiovascular Disease
Ortega, F. B., Lavie, C. J., & Blair, S. N. (2016) · Circulation Research · doi:10.1161/circresaha.115.306883 · Cited by 1,254
Self-citationBray, G. A., Frühbeck, G., Ryan, D. H., & Wilding, J. P. H. (2016) · The Lancet · doi:10.1016/s0140-6736(16)00271-3 · Cited by 1,036
Obesity and cardiovascular disease: revisiting an old relationship
Koliaki, C. C., Liatis, S., & Kokkinos, A. D. (2018) · Metabolism · doi:10.1016/j.metabol.2018.10.011 · Cited by 771
Metadata
- Authors
- Lavie, C. J., De Schutter, A., & Milani, R. V.
- Affiliations
- The University of Queensland (AU)
- Corresponding author
- Lavie, Carl J.
- Venue
- Nature Reviews Endocrinology
- Published
- 2014-09-30
- Volume
- 11
- Issue
- 1
- Pages
- 55-62
- ISSN
- 1759-5029 (ISSN-L)
- 1759-5037
- OpenAlex
- W2043273449
- Cited by
- 266
- References
- 83
- Citations by year
- 2026: 14 · 2025: 26 · 2024: 16 · 2023: 28 · 2022: 19 · 2021: 14 · 2020: 22 · 2019: 22 · 2018: 22 · 2017: 24 · 2016: 33 · 2015: 21 · 2014: 5
- FWCI
- 4.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Reviews Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Keywords
- obesity paradox, metabolically healthy obesity, obesity, cardiovascular health, cardiorespiratory fitness, overweight, morbid obesity, cardiovascular disease prevention, weight loss, body mass index
- MeSH terms
- Cardiovascular Diseases, Humans, Obesity, Risk Factors, Thinness, United States, Kaplan-Meier Estimate, Physical Conditioning, Human
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