Could Obesity Protect You From Congestive Heart Failure?


A recent study titled “The Obesity Paradox in Men Versus Women With Systolic Heart Failure” published in the American Journal of Cardiology had some very interesting results.

The authors from UCLA looked at patients over a couple of decades that were treated with significant advanced congestive heart failure and calculated their body mass index or BMI. Your BMI is a number that doctors use to determine whether someone is obese or not and can be calculated in a fair amount of online BMI calculators. Typically BMI is calculated by taking into account your weight and height.

The authors found if these patients were at least overweight they had less of a chance of dying or eventually needing a heart transplant. This was true for both men and women in the study. The authors are unable to say why these patients with obesity did better than those at ideal body weight and suggest further studies in trying to determine what the exact relationship is.

We need to be careful in how these results are interpreted.

First, this is a unique patient population. It has been well established that advanced chronic congestive heart failure can lead to significant weight loss, and thus is already known as a poor prognostic factor in these patients.

Second, being overweight is clear risk factor for developing multiple well-established cardiac risk factors like high blood pressure, high cholesterol, and diabetes. There is no doubt that these risk factors go on to contribute to chronic heart disease in a variety of forms.

Finally, I worry that the patients will see headlines about this study and think it is acceptable to gain weight if one has congestive heart failure. Patients with this condition need to monitor their weight very carefully, often on a daily basis. Weight gain, even as little as 3-5 pounds over a few days, could be the first sign of fluid retention which could then lead to shortness of breath, swelling, and a trip to the emergency room.

I would encourage patients with congestive heart failure to discuss these results of this study with their physicians.

About the author

Dr. Rafic Berbarie
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Dr. Rafic Berbarie is the medical director of Cardiac Rehab at Baylor Jack and Jane Hamilton Heart and Vascular Hospital. He received his doctorate from the University of Texas Medical Branch in Galveston.

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Could Obesity Protect You From Congestive Heart Failure?