'Obesity paradox' misunderstands the biology of optimal weight throughout the life cycle

Int J Obes (Lond). 2015 Jan;39(1):82-4. doi: 10.1038/ijo.2014.59. Epub 2014 Apr 15.


The 'obesity paradox' refers to observations that run counter to the thesis that normal weight (BMI 18.5-24.9 g/m(2)) provides the lowest mortality and higher weight is associated with greater mortality. We argue that the weight of lowest mortality is influenced by aging and chronic disease, with mortality advantage extending into the overweight and even class I obese ranges under some circumstances. A focus on quality nutrition, physical activity, fitness, and maintaining function in these weight ranges may be preferable to a focus on intentional weight loss, which has uncertain effects. The 'obesity paradox' is no 'paradox' if one defines and interprets 'ideal' weight appropriately.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aging
  • Body Fat Distribution
  • Body Mass Index
  • Cardiovascular Diseases / mortality
  • Cardiovascular Diseases / physiopathology
  • Exercise
  • Humans
  • Life Style
  • Nutritional Status
  • Obesity / mortality*
  • Obesity / physiopathology
  • Risk Factors
  • Time Factors
  • Weight Loss