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Obesity aids in illness survival

Sharon Kirkey, Canwest News Service
Published: Monday, March 10, 2008

Fat people have a survival edge over skinnier people in the face of critical illness, new research shows.

In the latest example of the phenomenon known as the "obesity survival paradox," American researchers found that while critically ill obese patients spend more days on mechanical ventilators and in intensive care units than thinner ICU patients, they're more likely to survive.

And there are several theories as to why: One holds that an abundant supply of fat tissue acts like a factory, churning out chemicals called adipokines that help fight inflammation and infections such as sepsis -- overwhelming bloodstream infections that are the leading cause of death in an ICU.

In addition, during severe illnesses, the body breaks down muscle protein and glycogen, the body's primary source of stored energy. Obese people may be better able to cope because of greater nutritional reserves.

"With the increased rates of obesity, we're seeing more and more morbidly obese patients in the intensive care unit," says lead author Dr. Folu Akinnusi, of the University of Buffalo's division of pulmonary, critical care and sleep medicine.

"We thought, if they were at increased risk and likely to die, we needed to do something, we needed a different kind of intervention to try and reduce or stem that wave of increased mortality."

Instead, they found the opposite to be true. Akinnusi hopes the findings will make doctors think twice about "subconsciously writing off the obese."

"A lot of times, people have less of an expectation" that they will survive, he says. "If we know they're not at greater risk then you're very likely to give them as much of a chance as everyone else and do the most you can for them."

The study is the latest to show how the very condition that causes multiple health problems -- including high blood pressure, heart disease, stroke and diabetes -- may protect people during serious illness or injury.

Other researchers have found that obese people with kidney failure, heart failure and chronic obstructive lung disease do better than skinnier patients.

No one is suggesting obesity is a good thing, Akinnusi says.