Cited by 170Obesity, Physical Activity, DietDiabetes, Cardiovascular Risks, and LipoproteinsPhysical Activity and Health

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Obesity paradoxes

McAuley, Paul A., Blair, Steven N.·2011·Journal of Sports Sciences

DOI 10.1080/02640414.2011.553965

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Abstract

In this review, we examine the original obesity paradox phenomenon (i.e. in cardiovascular disease populations, obese patients survive better), as well as three other related paradoxes (pre-obesity, "fat but fit" theory, and "healthy" obesity). An obesity paradox has been reported in a range of cardiovascular and non-cardiovascular conditions. Pre-obesity (defined as a body mass index of 25.0-29.9 kg · m⁻²) presents another paradox. Whereas "overweight" implies increased risk, it is in fact associated with decreased mortality risk compared with normal weight. Another paradox concerns the observation than when fitness is taken into account, the mortality risk associated with obesity is offset. The final paradox under consideration is the presence of a sizeable subset of obese individuals who are otherwise healthy. Consequently, a large segment of the overweight and obese population is not at increased risk for premature death. It appears therefore that low cardiorespiratory fitness and inactivity are a greater health threat than obesity, suggesting that more emphasis should be placed on increasing leisure time physical activity and cardiorespiratory fitness as the main strategy for reducing mortality risk in the broad population of overweight and obese adults.

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Authors: McAuley, P. A., & Blair, S. N.
Affiliations: Winston-Salem State University (US)
University of South Carolina (US)
Corresponding author: McAuley, Paul A.
ORCID: McAuley, Paul A.
Blair, Steven N.
Venue: Journal of Sports Sciences
Publisher: Informa UK Limited
Published: 2011-05
Volume: 29
Issue: 8
Pages: 773-782
ISSN: 0264-0414 (ISSN-L)
1466-447X
DOI: 10.1080/02640414.2011.553965
OpenAlex: W4235277499
Cited by: 170
References: 85
Citations by year: 2026: 6 · 2025: 5 · 2024: 6 · 2023: 8 · 2022: 7 · 2021: 3 · 2020: 14 · 2019: 9 · 2018: 7 · 2017: 15 · 2016: 20 · 2015: 20 · 2014: 22 · 2013: 13 · 2012: 11
FWCI: 2.37
Type: journal article
Language: en
Open access: closed
Locations: Journal of Sports Sciences (publishedVersion)
PubMed (publishedVersion)
Scholar Commons (University of South Carolina) (submittedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
Keywords: obesity paradox, pre-obesity, overweight, metabolically healthy obesity, cardiorespiratory fitness, physical inactivity, mortality risk, cardiovascular disease, body mass index, physical activity
MeSH terms: Aged, Female, Humans, Male, Middle Aged, Models, Theoretical, Obesity, Physical Fitness, Body Mass Index

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