Thursday, July 3, 2008

Obesity may offer some protection after stenting

Really?
Why is it always a paradox when doctors/researchers find out that being fat can be beneficial if you have a catastrophic illness?
Paradoxically, obesity may offer some protection against heart-related "events," like heart attack, in people who have a stent placed to prop open a clogged coronary artery, research shows.
In a study, researchers found that obese patients who had stents placed in diseased arteries had a lower incidence of adverse cardiac events than their normal-weight counterparts.

Could it possibly be that when something requires surgical intervention of any kind, it's helpful to have those fat reserves to call upon? If you don't have those fat reserves, your body is going to go after your muscles (and your heart is a muscle, your body doesn't distinguish between leg muscle, say, and heart muscle, it just goes after muscle if there's no fat to burn).
Khattab's team analyzed the outcomes at one year for 607 patients with coronary artery disease who were treated with stents that release the immune-suppressing drug sirolimus.
The group included 176 normal weight patients, 289 overweight patients, and 142 obese patients
At 30 days, the incidence of adverse cardiac events was 3.4 percent in the normal weight group and 3.1 percent in overweight patients, compared with just 2.8 percent in obese patients.

So yeah, TEH FATZ is going to kill us, but it looks to me like it's more dangerous to be normal or thin if you have blocked arteries and need a stent placed.
At one year, the combined cumulative incidence of death, heart attack, stroke, and repeat angioplasty or other "revascularization" procedure was higher in the normal weight patients (10.8 percent) and the overweight patients (11.8 percent) than in the obese patients (7.0 percent).

Ya know, I think I'll take my chances with being "super morbidly death-looking-for-a-place-to-happen obese". At least if I have a catastrophic illness, my odds of surviving it are a hell of a lot better than if I were thin (which ain't happening anyway).

10 comments:

  1. "super morbidly death-looking-for-a-place-to-happen obese"

    Can't. stop. laughing! The next time my doctor tries to scare me into losing weight I'm going to think of this and giggle my brains out.

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  2. "Why is it always a paradox when doctors/researchers find out that being fat can be beneficial if you have a catastrophic illness?"

    Because they've made too many assumptions about causation and even now refuse to believe their own eyes, their own research. They can't stop calling it a paradox even though there are now so many paradoxes it makes no logical sense to keep calling them paradoxes.

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  3. This isn't terribly surprising considering the number of times the 'obesity paradox' has come into play with heart-related ailments.

    It is, however, very comforting at the moment since Mr. Twistie's doctor has been discussing the serious possibility of a stent for him.

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  4. Vesta you kill me. You always make me laugh or give me a new perspective on life. You know what's wonderful about you? You like yourself....and that is so very attractive.

    But....and there is always a but from me... cause I gotta make you think as well.....

    Did you happen to notice that the overweight and obese patients were higher in number? Coincidence? I don't know; maybe not.

    I can tell you this, at my heaviest which, I might add was quite substantial for my 5'2 frame I had an MI and was stented. The stent did well, I'll admit it...but my heart didn't. I lost a ton of weight....and then had a major MI with open heart surgery....go figure.

    Love you Vesta...keep on keeeping on!

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  5. "If you don't have those fat reserves, your body is going to go after your muscles (and your heart is a muscle, your body doesn't distinguish between leg muscle, say, and heart muscle, it just goes after muscle if there's no fat to burn)" Do you have any back-up for this statement? If I recall my biology, heart muscle is a specific type of muscle not found anywhere else in the body. I've never read of anyone who's lost so much weight that heart muscles is damaged by just that fact alone.

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  6. karen h - I don't remember exactly where I read it, but I remember reading a study that said anorexics can have damaged hearts from losing large amounts of weight. I just did some research (typed in anorexia and heart damage) and this is what the Mayo Clinic in Rochester MN has to say about it: http://tinyurl.com/6dwmdc
    That was just the first of several thousand links. So, yeah, losing large amounts of weight through starvation (which is exactly what diets and WLS are) can cause heart damage.

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  7. Isn't it pretty much a given that one of the most common causes of death among anorexics and bulimics is heart attack...even if they're just teenagers? I haven't heard of many fat teenagers having heart attacks, but I've definitely heard of anorexics having them. http://www.something-fishy.org/dangers/heartstroke.php

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  8. I should note that that doesn't mean the body is necessarily consuming the heart muscle, or that that's the only cause of heart attacks with starvation; electrolyte imbalances are a serious problem too. However, the Ancel Keys study found that after the semi-starvation of his subjects, their heart *volumes* had decreased by 20%. That sounds pretty darned suggestive to me.

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  9. ms. heathen - I like that phrase simply because it's just so over-the-top exaggerated, just like the "obesity epi-panic". Really, if my fat is going to kill me at a young age (which I don't think is likely, since I'm 54-going-on-55), why not make absurd fun of it?

    annie - I think they've brainwashed themselves into believing those assumptions and have too much invested in them to be able to admit they were wrong, so therefore it has to be a paradox, it can't be fact.

    twistie - my aunt has had stents placed, and has meds to take, and as long as I've known her, she's been a bit chunky (not what I would call fat, by any means, just stocky and well-built). She seems to be doing pretty well, and she's almost 76.

    my own woman - Hey, glad I can make you laugh, it's much better than crying....lol. I'm thinking that the reason they had more "overweight"/"obese" people in the study is because there are more people in those categories than are normal weight (if you believe the statistics, at least 2/3 of the population fall into the OW/O range).
    Now I'm not saying your weight loss is the reason you had a major MI with open heart surgery, but it's a possibility. Things like that always make me wonder, especially when doctors push weight loss after an event like that as a way to keep it from happening again, and the weight loss doesn't prevent it. Maybe the weight loss gets rid of the reserves you need in order to get well?

    annie - The Ancel Keys study may not have come right out and said the body was consuming heart muscle, but if the heart's losing volume, where else is that heart muscle going? That seems indicative of consumption by the body (or maybe it's just wasting away due to lack of nutrition, but seems like a distinction without a difference to me).

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  10. "ms. heathen - I like that phrase simply because it's just so over-the-top exaggerated, just like the "obesity epi-panic". Really, if my fat is going to kill me at a young age (which I don't think is likely, since I'm 54-going-on-55), why not make absurd fun of it?"

    Though you have to admit, it's sort of hard to parody the ever-worsening terms; they're sort of self-parodying. First there was overweight and obese. Then when obese stopped scaring people it was "morbidly obese." But...with so many people living pretty darn full lives who fall into the "morbidly obese" category (I remember the first time I fit the label, and thinking - "But there's nothing wrong with me and I'm active, with healthy kids, and I can do pretty much everything everyone else does, so wtf?") then THAT stopped scaring people. (I take it you saw that recent fatosphere post where (Dynamo, I think) posted pictures of "morbidly obese" women who were doing active things, and wearing nice clothes, and generally doing fine. So they had to come up with something new - "SUPER morbidly obese."

    My husband laughed the last time he heard that one, and said, "Super DUPER morbidly obese is next."

    I'm all for terms that make fun of this ridiculous trend :) SDMOATELFAPTD (super duper morbidly obese about to explode looking for a place to die.) We should run a contest for the funniest, or just keep building on them and then make it an official acronym. It doesn't have to spell anything, it can be FUBAR :D

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