Fitness Vs. Fatness: The Obesity Paradox

Friday, October 10, 2014 at 11:05 am

LAS VEGAS—During every medical visit, healthcare providers should gauge the physical activity of their patients, explain the benefits of being physically active, and provide counseling and encouragement to their patients to implement exercising initiatives.

Jane Nelson Worel, MS, ANP-BC, a lecturer for the Doctor of Nursing Practice program at the University of Wisconsin’s School of Nursing, will present an informative deconstruction of the obesity paradox during her session titled, “Fitness Vs. Fatness: The Obesity Paradox.”


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Worel defines the obesity paradox as the circumstance in which, “overweight and obese people with established cardiovascular disease, (CVD)…have a better prognosis compared with non-overweight/non-obese patients.”1 She will discuss this paradox in relation to the morbidity and mortality of cardiovascular disease, discussing the evidentiary benefits of fitness and exercise on cardiovascular health (apart from weight loss), and analyzing the frequency and quantity of exercise required to influence weight loss.

According to a study by Lavie et al, obesity comprises approximately 20% of all-cause mortality and it is second to tobacco abuse as the cause of preventable deaths in the United States. Researchers found that 70% of adults are obese or overweight in the United States.1

While body mass index is namely used to measure obesity, Worel will suggest that adiposity may better be assessed through measuring waist circumference and waist-to-hip-ratio.

Worel wants to encourage doctors to advise patients in purposeful weight loss strategies, focusing on exercise to help reduce cardiovascular-associated risks.

“Often we assume that counseling about exercise will take too much time, or worse yet, that it will be wasted time, because patients won’t do it anyway. With the right tools, exercise counseling can be both efficient and effective,” said Worel.

-Michelle Canales


  1. Lavie CJ, Milani RV, Ventura HO. Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss. J Am Col Cardiol. 2009;53(21):1925-1932.