Revisiting the obesity paradox: visceral fat distribution outperforms BMI in predicting mortality and cardiometabolic risk
In this cross-sectional study of U.S. adults, visceral fat accumulation and an unfavorable fat distribution ratio were more strongly associated with mortality and CMD risk than BMI alone. The apparent survival advantage of elevated BMI was attenuated after accounting for fat distribution and metabolic health. These findings suggest that clinical assessment of obesity-related risk should incorporate measures of fat distribution and metabolic phenotype beyond BMI.
Authors
- Kan Pan
- Weicheng Huang (ORCID: https://orcid.org/0000-0003-3466-5169)
- Tingting Zhao (ORCID: https://orcid.org/0009-0009-3003-2779)
- Xinying Chen (ORCID: https://orcid.org/0000-0002-5052-4991)
- zhaoting bu
- Changhong Xu
- Nuo Xu (ORCID: https://orcid.org/0009-0001-3405-4846)
- Bing Yin
- Huimin Chen
- Li Deng
- Hanping Shi
- Hong Zhao
- Mingjian Zhao
- Qi Zhang
- Xiaoyue Liu
Institutions
- Guangxi Medical University (CN)
- Capital Medical University (CN)
- Wenzhou Medical University (CN)
- First Affiliated Hospital of Wenzhou Medical University (CN)
- Chinese PLA General Hospital (CN)
- Yale University (US)
- First Affiliated Hospital of GuangXi Medical University (CN)
- Beijing Shijitan Hospital (CN)
Publication Details
- Journal
- International Journal of Surgery
- Published
- 2026-02-03
- DOI
- https://doi.org/10.1097/js9.0000000000004912
- Primary Topic
- Nutrition and Health in Aging
- Type
- article
- Field-Weighted Citation Impact
- 0.00