The Obesity Paradox: It Increases Diabetes Risk But Can Help Cancer Patients Respond To Treatment

Being overweight or obese (as defined by having a high BMI, which measures weight relative to height), has been linked to countless health issues: cancer, diabetes, cardiovascular health, high blood pressure, high cholesterol, insulin resistance, and more. As a person’s BMI increases, risk of heart disease, stroke, and type 2 diabetes increase.

The World Health Organization (WHO) estimates that 2.8 million people die every year due to being overweight and obese and the health issues that go along with that.

However, a group of researchers has found a tiny silver lining: people who are obese or overweight and have cancer seem to respond better to immunotherapy treatment.

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The study was published in the journal JAMA Oncology and led by researchers from Flinders University in Australia.

Atezolizumab is an immunotherapy treatment that’s in clinical trials for non-small-cell lung cancer (NSCLC). Looking at a pool of 1,434 participants who were taking the drug in four different clinical trials, researchers at Flinders compared each person’s responsiveness to atezolizumab to their BMI. Nearly half the participants (49%) were normal weight, 34% were overweight, and 7% were obese.

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They found that those with a higher BMI had a higher responsiveness to the drug, and a significant reduction in mortality.

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“Previous studies have explored a concept called as ‘obesity paradox’ where obesity is associated with increased risks for developing certain cancers and, counter-intuitively, may protect and give greater survival benefits in certain individuals,” said Ganessan Kichenadasse, a medical oncology researcher at the Flinders Centre for Innovation in Cancer. “Our study provides new evidence to support the hypothesis that high BMI and obesity may be associated with response to immunotherapy.”

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Despite the positive results in the study related to high BMI, researchers emphasized that maintaining a healthy weight and lifestyle are crucial to overall health.

“This is an interesting outcome and it raises the potential to investigate further with other cancers and other anti-cancer drugs,” Kichenadasse said. “We need to do further studies into the possible link between BMI and related inflammation, which might help to understand the mechanisms behind paradoxical response to this form of cancer treatment.”

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