Being overweight or obese does not lead to improved survival among patients with type 2 diabetes. The large-scale study led by Harvard School of Public Health (HSPH) researchers refutes previous studies that have suggested that, for people with diabetes, being overweight or obese could lead to lower mortality for people compared with normal-weight persons — the so-called “obesity paradox.”

The study appears in the January 16 issue of the New England Journal of Medicine.

“These data dispel the notion that being overweight or obese confers survival advantage among diabetic patients,” said Frank Hu, professor of nutrition and epidemiology at HSPH and senior author of the study. “Clearly, weight management is an important therapeutic strategy for overweight or obese individuals with type 2 diabetes.”

The researchers analyzed data from 8,970 women in the Brigham and Women’s Hospital-based Nurses’ Health Study (NHS) and 2,457 men in the Health Professionals Follow-up Study (HPFS) with type 2 diabetes. They calculated participants’ body-mass index (BMI) shortly before the diagnosis of diabetes and excluded participants reporting a history of diabetes at baseline or cardiovascular disease or cancer before they were diagnosed with diabetes; underweight participants were also excluded. Participants were followed for a maximum of 36 years (NHS) and 26 years (HPFS). A total of 3,083 deaths were recorded.

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