Obesity Paradox in the Elderly: Is Fatter Really Fitter?

Obesity is a highly prevalent metabolic disorder affecting most of the world and all sections of society, from young children to the elderly. Obesity is a common problem in the elderly, and is associated with increased all-cause and cardiovascular morbidity and mortality. Impaired physical function and decreased quality of life accompany development of the complications associated with obesity, such as diabetes and vascular disorders. Despite these adverse associations, numerous studies indicate an ‘obesity paradox’, in that overweight and obese patients with cardiovascular diseases including heart failure, hypertension and coronary heart disease have a favorable prognosis. Here, we summarize the supporting evidence for the obesity paradox in elderly adults with these cardiovascular conditions, discuss the pros and cons of being obese and conclude with a statement on the optimal weight for a healthy living.