Overweight May Decrease Mortality Risk in Type 2 Diabetes

Weight loss linked to hot flash reduction
Weight loss linked to hot flash reduction
Patients with type 2 diabetes who were overweight but not obese had a decreased risk for death.

Being overweight but not obese was linked to a decreased risk for death in patients with type 2 diabetes, new data published in the Annals of Internal Medicine suggest.

Although obesity is a known risk factor for cardiovascular disease (CVD) and type 2 diabetes, research has shown that overweight patients with CVD live longer than normal-weight patients with CVD, according to a press release. Consequently, the researchers sought to see if the same was true in patients with diabetes.

For the prospective cohort study, they evaluated 10,568 patients with type 2 diabetes (median age, 63 years; 54% men) and no known CVD who were followed for a median of 10.6 years using data from the National Health Service in England. Information on CV events and all-cause mortality were collected.

Results indicated that the rate of cardiac events, including acute coronary syndrome, cerebrovascular accidents and heart failure, was higher among overweight or obese patients, defined as a BMI greater than 25, than that of normal-weight patients.

Even so, being overweight, defined as BMI between 25 and 29.9, was linked to a lower risk for mortality, while mortality risk for obese patients, defined as a BMI greater than 30, was similar to that of normal-weight people.

Data also showed that prognosis was worse for patients with low body weight.

“In this cohort, patients with type 2 diabetes who were overweight or obese were more likely to be hospitalized for cardiovascular reasons,” they wrote. Being overweight was associated with a lower mortality risk, but being obese was not.”

The researchers speculated that several factors could explain the “obesity paradox” in type 2 diabetes.

For instance, type 2 diabetes that develops from the metabolic stress of obesity may differ from that which develops in the absence of obesity. Additionally, alcohol and tobacco use may be higher in people with type 2 diabetes and a low BMI. Moreover, diabetes may be diagnosed earlier in obese patients, as they are more likely to be evaluated for the condition.

However, the study data do not identify an ideal BMI, the researchers wrote, and people should still attempt to make healthy lifestyle choices.


  1. Costanzo P et al. Ann Intern Med. 2015;162(9):610-618.