ReviewFrontiers in nutrition2020
Obesity or BMI Paradox? Beneath the Tip of the Iceberg.
Review in Frontiers in nutrition, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 152 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
152 citing papers in PubMed, 2 syntheses or guidelines pooled it, 257 citations in OpenAlex.
- Pooled it
- Association between metabolically healthy obesity and metastasis in lung cancer patients - a systematic review and meta-analysis.Frontiers in endocrinology · 2023Pooled it
- Improving Muscle Function Through a Multimodal Behavioural Intervention for Knee Osteoarthritis and Obesity: The POMELO Trial.Journal of cachexia, sarcopenia and muscle · 2025Trial
- Visceral fat score predicts diabetic kidney disease: analysis of 20 years of U.S. NHANES data.Renal failure · 2026Article
- Deep learning-derived abdominal adiposity phenotypes and 28-day mortality in sepsis.International journal of obesity (2005) · 2026Article
- Association of body composition with all-cause mortality among U.S. adults with osteoporosis or osteopenia: a population-based study.Hormones (Athens, Greece) · 2026Article
- Nationwide trends in incidence and in-hospital mortality of ARDS in Germany, 2008-2022.Scientific reports · 2026Article
- Risk factors associated with saphenous vein graft in-stent restenosis.General thoracic and cardiovascular surgery · 2026Article
- Six anthropometric indices and all-cause mortality in ageing populations: an observational cohort study in six longitudinal studies.BMC public health · 2026Observational
- Adiposity Rebound or Fat-Free Mass Anabolism in Children-Challenging a 42-Year-Old BMI Puzzle with Waist-to-Height Ratio: The ASNF-NNF 2025 Inaugural Flemming Quaade Award for Innovation in Childhood Obesity Lecture.The Journal of nutrition · 2026Article
- Sarcopenia and physical performance among older adults with increased body mass index and falls.Scientific reports · 2026Article
- Obesity Subtypes and Longitudinal Trajectories of Function Over Seven Years of Follow-Up: Data From the Multicenter Osteoarthritis Study.Arthritis care & research · 2026Article
- Obesity strengthens the associations between sarcopenia and both frailty and hospitalization, whereas reduces the risk of mortality.The journal of nutrition, health & aging · 2026Article
- Uncommon Combination of Low Alanine Aminotransferase and High Fatty Liver Index Associated With High Charlson Comorbidity Index: Insights From the K7Ps-Study-7.Journal of clinical medicine research · 2026Article
- Trajectory of Body Mass Index and Frailty Among Older People in Southern Brazil: A Longitudinal Study.Nutrients · 2026Article
- Association of CTI and its obesity-related derivatives with incident depression among middle-aged and older adults across CKM stages 0-4: a nationwide prospective cohort study and external clinical validation.Frontiers in endocrinology · 2026Article
- Evaluating Body Mass Index to High-Density Lipoprotein Cholesterol (BMI/HDL-C) Ratio in Predicting Coronary Artery Disease: A Multicenter Study.Vascular health and risk management · 2026Observational
- Body roundness index: superior predictors of intramuscular fat infiltration in general population.Frontiers in nutrition · 2026Article
- Obesity and obstructive sleep apnea: from pathophysiology to current clinical approaches.Respiratory research & clinical practice · 2026Review
- Obesity Is Associated with a Lower Risk of Mortality and Readmission in Heart Failure Patients with Diabetes.Biomedicines · 2025Article
92 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The obesity paradox refers to extant evidence showing that obesity in older subjects or in patients with several chronic diseases may be protective and associated with decreased mortality. A number of mechanisms have been postulated to support the existence of obesity paradox; however, marked heterogeneity was found across studies and this has cast doubt on the actual presence of this phenomenon. The aim of the present narrative review is to summarize evidence underlying the concept of obesity paradox, focusing on limitations and bias related to this phenomenon, with emphasis on the use of body mass index (BMI). A major cause of the discrepancy between studies may be related to the use of BMI in the definition of obesity, that should consider, instead, excess body fat as the main characteristic of this disease and as the unique determinant of its complications. In addition, the adjustment for potential confounders (e.g., stage and grade of diseases, smoking habit, inability to capture the presence of signs of undernutrition in the normal-weight comparative group, consideration of body composition) may significantly scale down the protective role of obesity in terms of mortality. However, it is still necessary to acknowledge few biases (e.g., reverse causation, attrition bias, selection bias of healthy obese subjects or resilient survivors) that would still apply to obesity even when defined according with body composition. Further research should be prompted in order to promote correct phenotyping of patients in order to capture properly the trajectories of mortality in a number of diseases.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.