To the Editor Khan et al1 confirm in their 2018 study that obesity is a risk factor in disease-free, healthy populations (ie, in primary prevention). We concur that obesity is a population risk factor for incident disease. However, the authors’ finding is unsuitable to address the potential advantages of obesity in certain clinically relevant disease conditions that are collectively addressed in a condensed form as the obesity paradox or the obesity paradigm.2
Doehner W, Kalantar-Zadeh K, Anker SD. The Obesity Paradigm and Lifetime Risk of Cardiovascular Disease. JAMA Cardiol. 2018;3(9):895–896. doi:10.1001/jamacardio.2018.1837
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