Mixed
Among adults with diabetes, higher BMI (overweight and obese categories) is not associated with increased all-cause mortality compared to normal weight, contradicting the U-shaped mortality curve observed in the general population.
For people with diabetes, maintaining a 'normal' BMI (18.5-24.9) does not necessarily confer a mortality advantage over being overweight or obese, based on this large US study. However, this does not mean obesity is 'healthy.' It suggests that other factors like glycemic control (HbA1c), blood pressure, and smoking status are critical. Patients should focus on overall metabolic health rather than just weight loss, especially if they have been diagnosed with diabetes for a while.
In a nationally representative sample of the non-institutionalised US population with diabetes, BMI and waist circumference were not associated with risk of mortality.
Why this rating
Large, nationally representative prospective cohort (NHANES III) with rigorous adjustment for confounders and exclusion of early deaths to mitigate reverse causality.
Source
The relationship of adiposity and mortality among people with diabetes in the US general population: a prospective cohort study
Andy Menke et al. · BMJ Open · 2014
DOI 10.1136/bmjopen-2014-005671
Related findings · Mixed
- Bariatric surgery (VSG and RYGB) is the most effective and sustainable treatment for obesity, producing marked and sustained weight loss that non-surgical interventions cannot match.Strong
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- For patients with Class III obesity (BMI >39.9 kg/m2), metabolic bariatric surgery (MBS) is significantly more effective than any currently approved medication, with BilioPancreatic Diversion (BPD) showing the highest estimated weight loss.Strong
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