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  • Letter to the Editor
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Journals should no longer accept ‘obesity paradox’ articles

International Journal of Obesity volume 42, pages 584–585 (2018)Cite this article

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Banack et al make a very clear case in the latest issue of the International Journal of Obesity that most articles published on the ‘obesity paradox’ are not able to answer the question they purport to address: what level of future health risk (for example, mortality) does obesity confer in those with an obesity-related disease?.1 As the authors indicate, collider bias prevents us from being able to answer this question using a cohort of individuals with the obesity-related disease in question and obesity measured at baseline.

However, these authors have made this case a number of times since 2013,2, 3, 4 with no apparent effect on publishing practices. The number of articles on the ‘obesity paradox’ has continued to increase year on year since 2010. Last year alone these articles included meta-analyses in Circulation and the International Journal of Obesity concluding on the protective effects of higher body mass index in those with an obesity-related disease.5, 6

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References

  1. Banack HR, Stokes A . The 'obesity paradox' may not be a paradox at all. Int J Obes 2017; 41: 1162–1163.

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  2. Banack HR, Kaufman JS . From bad to worse: collider stratification amplifies confounding bias in the ‘obesity paradox’. Eur J Epidemiol 2015; 30: 1111–1114.

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  3. Banack HR, Kaufman JS . The ‘obesity paradox’ explained. Epidemiology 2013; 24: 461–462.

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  8. Kritchevsky SB, Beavers KM, Miller ME, Shea MK, Houston DK, Kitzman DW et al. Intentional weight loss and all-cause mortality: a meta-analysis of randomized clinical trials. PLoS One 2015; 10: e0121993.

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  9. Look Ahead Research Group. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med 2013; 369: 145–154.

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Acknowledgements

Thanks to Janitha Hettiarachchi and Jonathan Shaw for useful discussions on this issue. Anna Peeters is supported by a National Health and Medical Research Council Career Development Award.

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Authors and Affiliations

  1. Professor of Epidemiology and Equity in Public Health, Global Obesity Centre (GLOBE), World Health Organization Collaborating Centre for Obesity Prevention, School of Health & Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia

    A Peeters

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Correspondence to A Peeters.

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Peeters, A. Journals should no longer accept ‘obesity paradox’ articles. Int J Obes 42, 584–585 (2018). https://doi.org/10.1038/ijo.2017.259

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