Premium
Selection bias: A missing factor in the obesity paradox debate
Author(s) -
Robinson Whitney R.,
Furberg Helena,
Banack Hailey R.
Publication year - 2014
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.20666
Subject(s) - obesity paradox , obesity , selection bias , disease , population , risk factor , medicine , selection (genetic algorithm) , outcome (game theory) , demography , economics , environmental health , pathology , artificial intelligence , computer science , mathematical economics , overweight , sociology
Dear Drs. Ravussin and Ryan: The September issue of Obesity featured articles by Tobias and Hu (1) and Flegal and KalantarZadeh (2) that explored the observation that, in clinical populations, such as individuals with heart failure, chronic kidney disease, or diabetes, those with higher BMI often have lower mortality rates than leaner individuals. The articles disagree whether this phenomenon, known as the obesity paradox, is a true causal effect. Flegal and KalantarZadeh assert that the research on the obesity paradox is consistent with greater BMI conferring “modest survival advantages” (2). Tobias and Hu disagree, arguing that the obesity paradox is likely an “artifact of methodological limitations” (1).