Obesity Paradox and Smoking Gun: A Mystery of Statistical Confounding?

Abstract

The obesity paradox is a term coined for human conditions in which obesity is associated with a lower mortality than being underweight (i.e., body below normal or healthy body weight). Smoking is often cited as a key cofounder of obesity paradox but how smoking causes obesity paradox is unknown. Here we highlight that the obesity paradox can be attributed to insulin resistance and aberrant lipolysis in cardiovascular diseases.