The Obesity Paradox: How Does It Affect Patients With Diabetes?

Another study adds to growing evidence of a so-called “obesity paradox” among patients hospitalized for diabetes. The study was presented at the 2020 American Diabetes Association Scientific Sessions.

“Obesity has long been considered a risk factor for individual morbidity and mortality for numerous cardiopulmonary diseases. However, multiple studies have shown that patients who are overweight or obese according to BMI have better inpatient outcomes,” the researchers wrote.

They conducted an analysis of data from the Nationwide Inpatient Sample Database for 2016 and 2017, including approximately 1,031,009 hospitalizations with a principle diagnosis of diabetes type 1 or type 2. The presence of obesity, defined as a BMI of 30 or greater, was used to further categorize the patients.

Among the 1,031,009 hospitalizations, 15.6% had a secondary diagnosis of obesity, and in-hospital death occurred in 6285 cases (0.61%). When the researchers adjusted for age, sex, disease severity, and type of diabetes, they found that the adjusted odds ratio for mortality among patients with obesity was 0.63 (95% CI: 0.526 - 0 .762, p< 0.001) compared with patients without obesity. Obesity was, however, associated with higher total hospital charge and longer length of stay in the hospital.

“In patients hospitalized with a principal diagnosis of diabetes and its complications, obese patients had a statistically lower mortality rate. Hence, there seems to be growing evidence for the obesity paradox. More research needs to be done to determine the factors responsible for this recurrent phenomenon,” they concluded.

—Michael Potts


Shaka H, orto MEP, Gomez TMA, et al. 242-LB: The obesity paradox among patients hospitalized for diabetes and its complications: outcomes of the nationwide inpatient sample. Paper presented at: American Diabetes Association’s 80th Scientific Sessions; June 12-16, 2020; virtual meeting. doi:10.2337/db20-242-LB