obesity

Could Obesity Bias Help Explain the Obesity Paradox?

MedicalResearch.com Interview with:

Gurmukh Singh, MD, PhD, MBA Department of Pathology, Section of Clinical Pathology Walter Shepeard Professor of Pathology Section Chief, Clinical Pathology. Associate Medical Director, Clinical Laboratory GRMC and  Children's Hospital of Georgia 

Dr. Singh

Gurmukh Singh, MD, PhD, MBA
Department of Pathology, Section of Clinical Pathology
Walter Shepeard Professor of Pathology
Section Chief, Clinical Pathology.
Associate Medical Director, Clinical Laboratory GRMC and
Children’s Hospital of Georgia

MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by the obesity paradox?

Response: Obese people tend to get more diseases, such as hypertension, diabetes, cancer etc. However, when they get seriously ill, e.g., sick enough to require admission to intensive care treatment unit (ICU), obese people tend to have better outcomes than normal weight people.

MedicalResearch.com What are the main findings?

Response: We started with the hypothesis that obese people have abnormal baseline laboratory parameters and they get admitted to ICU with lower disease burden than normal weight people, thus creating the appearance of better outcomes. However, when we studied the laboratory testing results of obese people who were not otherwise sick, their laboratory findings were not meaningfully different from those of normal weight people. Thus the better outcomes in seriously ill obese people could not be attributed to poorer baseline laboratory results.

A plausible explanation, for which we do not have direct evidence, is that obese people are admitted to ICU due to bias by the care providers prompting them to admit obese people to ICU with lower disease burden than they may do for normal weight people.

MedicalResearch.com: What should readers take away from your report?

Response: Obese people have higher prevalence of serious health issue. Just because they do better when they get seriously ill, is not a reason to become obese.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: A systematic evaluation of the thought processes by which healthcare providers decided to admit patient to ICUs may support or argue against the idea that healthcare providers have a bias against obese people.

Any disclosures?

I serve as a member of Medical Advisory Board of HealthTap, but there is no conflict of this activity with the issues addressed in this paper.

Citation:

Okechukwu V Nwogbo, Asad Ullah, Gurmukh Singh. Obesity Paradox: Laboratory Findings in Uncomplicated Obesity. Is Bias a Plausible Explanation? The Journal of Applied Laboratory Medicine, 2020; DOI: 10.1093/jalm/jfaa049

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