The obesity paradox in cancer-moving beyond BMI
Open accessAbstract
Body mass index (BMI) and simple counts of weight are easy and available tools in the clinic and in research. Recent studies have shown that cancer patients with a low normal BMI (or those with weight loss) have worse outcomes than obese patients. These results suggest that obesity has a protective effect and has been termed the "obesity paradox." In this commentary, we discuss hypothetical explanations and take a step beyond BMI or simple weights alone to present other useful and more specific body composition metrics, such as muscle tissue mass, visceral fat mass, and subcutaneous fat mass. Body composition is highly variable between individuals with significant differences seen between various races and ages. Therefore, it is critical to consider that patients with the exact same BMI can have significantly different body compositions and different outcomes. We encourage further studies to examine body composition beyond BMI and to use other body composition metrics to develop individualized treatments and intervention strategies. Cancer Epidemiol Biomarkers Prev; 26(1); 13-16. ©2017 AACR SEE ALL THE ARTICLES IN THIS CEBP FOCUS SECTION, "THE OBESITY PARADOX IN CANCER EVIDENCE AND NEW DIRECTIONS".
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Recent studies show low/normal weight (BMI) is associated with poorer outcomes including increased mortality for cancer survivors when compared to obese cancer survivors - a phenomenon called the obesity paradox.
“Recent studies show low/normal weight (BMI) is associated with poorer outcomes including increased mortality for cancer survivors when compared to obese cancer survivors – a phenomenon called “the obesity paradox” (Strulov Shachar and Williams, 2017).”
From Myosteatosis in the Context of Skeletal Muscle Function Deficit: An Interdisciplinary Workshop at the National Institute on Aging (2020) · cites this paper as Strulov Shachar and Williams, 2017
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References 52 · Cited by 198
- Authors
- Strulov Shachar, S., & Williams, G. R.
- Affiliations
- 1UNC Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina.
- University of North Carolina at Chapel Hill (US)
- ORCID
- Williams, Grant R.
- Venue
- Cancer Epidemiology, Biomarkers & Prevention
- Published
- 2017-01-01
- Volume
- 26
- Issue
- 1
- Pages
- 13-16
- ISSN
- 1055-9965 (ISSN-L)
- 1538-7755
- PMC
- PMC5830139
- OpenAlex
- W2570629783
- Cited by
- 198
- References
- 52
- Citations by year
- 2026: 16 · 2025: 28 · 2024: 26 · 2023: 19 · 2022: 26 · 2021: 31 · 2020: 24 · 2019: 15 · 2018: 5 · 2017: 8
- FWCI
- 1.49
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cancer Epidemiology Biomarkers & Prevention (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Funders
- UNC (5K12CA120780-07)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Keywords
- obesity paradox, cancer, body mass index, body composition, muscle mass, visceral fat, subcutaneous adipose tissue, weight loss, oncological outcomes
- MeSH terms
- Adult, Aged, Body Composition, Body Weight, Female, Humans, Male, Middle Aged, Neoplasms, Obesity, Reference Values, Comorbidity, Body Mass Index, Survival Analysis, Risk Assessment
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