Can being overweight benefit those with Type 2 diabetes?
People with Type 2 diabetes who are overweight, but not obese, live longer than those who are normal-weight or underweight, which is known as the “obesity paradox” effect.
“People like to hear good news about their bad habits, and what people will likely focus on in this study is the aspect of overweight and longevity,” says Dr. Ashwani Garg, family medicine physician on staff at Advocate Sherman Hospital in Elgin, Ill. “But, what use is longevity without good health?”
Researchers followed more than 10,500 patients with Type 2 diabetes and no known cardiovascular disease for over 10 years. They also collected data about cardiovascular events and all-cause mortality.
The overweight and obese patients had an increased risk for cardiovascular events, but those who were overweight had a better survival rate compared to those who were underweight or normal-weight.
“The most important takeaway is that this study is not the message that being overweight is better for a diabetic, but that patients who have diabetes and are overweight or obese have an increased risk for cardiovascular disease,” Dr. Garg says. “Studies like this have to be interpreted with caution.”
Researchers offered possible explanations for the obesity paradox.
Those included Type 2 diabetes induced by the metabolic stress of obesity may fundamentally differ from that which develops in the absence of obesity, and patients with Type 2 diabetes and a low body mass index might have higher tobacco and alcohol consumption, leading contributing to both the development of diabetes and a lower BMI.
Obese patients may also be more likely to be checked for diabetes, leading to earlier diagnosis.
Researchers cautioned that the study’s results don’t suggest an ideal BMI and shouldn’t discourage patients from adopting a healthy lifestyle.
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