Central obesity at normal weight leads to increased risk of premature mortality

Central obesity is riskier in people at a normal weight than those who are obese or overweight.
Central obesity is riskier in people at a normal weight than those who are obese or overweight.

HealthDay News — Individuals with central obesity but of normal weight according to body mass index (BMI) have a higher risk of premature mortality than overweight or obese people, according to research published online Nov. 10 in the Annals of Internal Medicine.

For the study, a team led by Francisco Lopez-Jimenez, MD, a professor of medicine at the Mayo Clinic in Rochester, Minn., used data from a national survey to compare the risk of premature death among 15,184 adults. The mean follow-up time was 14 years. The researchers looked at BMI and waist-to-hip ratios.

The researchers found that a normal-weight male with more fat around the waist had an 87% increased risk of death during the study period compared to a man who was normal weight without central obesity. Compared to overweight or obese men (as measured solely by BMI, without specific waist size information), a normal-weight man with central obesity had more than twice the risk of dying early. Normal-weight women with central obesity had nearly a 50% increased risk of death during the study period versus a normal-weight woman whose weight was more equally distributed throughout her body. Compared to obese women (measured by BMI only), the normal-weight women with abdominal fat had a 32% higher risk of early death.

"These new data provide evidence that clinicians should look beyond BMI. Although assessing for total fat mass with BMI to identify patients at greater cardiovascular risk is a good start, it is not sufficient," writes the author of an accompanying editorial.

References

  1. Sahakyan KR, Somers VK, Rodriguez-Escudero JP, et al. Normal-weight central obesity: implications for total and cardiovascular mortality. Ann Intern Med. 2015; doi: 10.7326/M14-2525
  2. Poirier P. The many paradoxes of our modern world: is there really an obesity paradox or is it only a matter of adiposity assessment? Ann Intern Med. 2015; doi: 10.7326/M15-2435
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