Obesity paradox: does fat alter outcomes in chronic obstructive pulmonary disease?

The role of obesity and its influence on mortality in the general population has been well established. However, over the last decade, there has been substantial focus on the paradox that exists among the obese with various chronic diseases, where overweight and at least mild-moderately obese with these chronic diseases appear to have a better prognosis than do their leaner counterparts. Among them, congestive heart failure and coronary heart disease have received considerable attention. However, the influence of the obesity paradox on outcomes among patients with chronic obstructive pulmonary disease (COPD), including those requiring long-term oxygen therapy, has not been elucidated. This paper highlights the current research in this area and brings to light the lacunae that exists with regard to this paradox in COPD.