A September 2019 study of the protective benefit of obesity in established Heart Failure (“HF”), the so-called 'obesity paradox' by the University of Adelaide found,
"The obesity paradox is the observation, generally from large clinical registries or trials, that the presence of obesity confers a survival benefit over normal or underweight individuals,''
"There are a number of possible explanations for obesity paradox in HF including whether obese patients are diagnosed earlier in their disease course due to greater functional impairment, and also whether obese patients tolerate disease-modifying and prognostic medications compared with non-obese patients.
"In this meta-analysis, the data found a 'U-shaped' survival curve with the lowest mortality in overweight patients and a reduced mortality in the obese when compared with normal or underweight HF patients.
"This meta-analysis adds to the body of evidence supporting the clear link between obesity and HF, the effect of weight on prognosis of HF and the impact of weight loss on cardiac remodeling. We are now conducting a randomized controlled study assessing the impact of intentional weight loss (achieved through dietary intervention and prescribed exercise), in a HF population of obese patients. This will hopefully address the important clinical question of whether intentional weight loss is beneficial in this growing group of patients."