The Health Risk of Obesity—Better Metrics Imperative

The impact of a high BMI on mortality is in question, calling for a rethinking of how metabolic health is assessed. Obesity has increased worldwide; is a major risk factor for diabetes, cardiovascular disease, cancer, sleep apnea, nonalcoholic fatty liver disease, osteoarthritis, and other ailments; and has been associated with disability, mortality, and enormous health costs (1, 2). Despite these clear adverse consequences of obesity, some studies have suggested that obesity as defined by body mass index (BMI) improves survival under certain conditions (3–8). Here, we discuss the controversies surrounding the “obesity-mortality paradox” and offer potential mechanisms to explain the effects of obesity on health.

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