Obesity: Bring on the Jiggle?

The July issue of Veterinary Pathology brings us a timely review on “Models and Strategies in the Development of Antiobesity Drugs” by Agahi and Murphy. ¹ Drugs for obesity have been the holy grail for some time. Developing these has proved elusive, possibly because they target functions that are fundamentally integrated with most aspects of physiology. It is established that obesity increases the risk of developing diabetes, cardiovascular diseases, cancer, and other chronic diseases and leads to higher mortality. However, a recent comment in Science ² questions the relationship between the widely used metric for obesity, body mass index (BMI) and mortality. In 1 meta-analysis, grade 1 obesity (BMI 30–34.9) was not associated with higher mortality, and the overweight condition (BMI 25–29.9) accompanied significantly reduced mortality. ³ Mortality appears to be more closely related to the metabolic syndrome associated with excess visceral fat rather than peripheral stores, which may in fact be protective. The optimal weight that is predictive of mortality is likely to be dependent on age, sex, genetics, cardiometabolic fitness, preexisting diseases, and other factors. In addition, a new index, the body shape index (ABSI), which quantifies abdominal adiposity relative to BMI and height, is thought to be a better predictor of mortality than BMI. ⁴