Evidence mapPaperPMID 41400711Full record

ReviewCurrent cardiology reports2025

The Treatment of Obesity in the Context of the Obesity Paradox in Patients with Heart Failure: A Narrative Review.

Pamela L Alebna, Sarah Martey, Anurag Mehta, Carl J Lavie, Salvatore Carbone

Abstract readReview
In one paragraph

Review in Current cardiology reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Pamela L AlebnaPauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA.
Sarah MarteySchool of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
Anurag MehtaDivision of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Carl J LavieOchsner Clinical School, John Ochsner Heart and Vascular Institute, The University of Queensland School of Medicine, New Orleans, LA, USA.
Salvatore CarboneNutrition Program, EVMS School of Health Professions, Macon & Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, VA, USA. scarbone@odu.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purpose of reviewWhile excess adiposity is a known risk factor for incident heart failure ( HF), once the condition is established, observational data suggest that increased body mass index (BMI) may confer a survival advantage. This paradox has emphasized the underlying roles of cardiorespiratory fitness (CRF), and body composition, particularly lean mass (LM), in influencing clinical outcomes. RECENT

findingsIn this review, we explore the multifaceted nature of the obesity paradox in HF, with a focus on emerging anti-obesity incretin-mimetic therapies, such as glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) receptor agonists. These agents have demonstrated remarkable efficacy in weight reduction and favorable cardiovascular profiles in patients with HF with preserved ejection fraction (EF), yet their use in other HF populations, such as HF with reduced EF, raises important clinical questions and the urgent need for future research. Concerns include the potential for LM loss, implications for sarcopenic obesity, and the uncertain impact of weight loss on outcomes in patients who may not benefit from weight loss. We also highlight the need to assess therapeutic outcomes beyond BMI, incorporating measures of CRF, such as peak oxygen consumption (VO₂ peak), quality of life, and functional capacity, using tools such as the 6-minute walk test. Barriers to implementation, including cost, provider hesitation, insurance restrictions, and patient level challenges are also reviewed. Finally, we call for future research using contemporary cohorts and advanced phenotyping to reevaluate the obesity paradox in the context of modern pharmacologic interventions. As obesity treatment continues to evolve, a patient-centered, individualized approach that integrates body composition, functional status, and comorbid conditions will be essential in optimizing care for individuals with HF.

Indexed as

Anti-Obesity AgentsHeart FailureObesityBody CompositionBody Mass IndexCardiorespiratory FitnessGlucagon-Like Peptide-1 Receptor AgonistsHumansObesity ParadoxWeight LossAnti-Obesity AgentsGlucagon-Like Peptide-1 Receptor AgonistsAnti-obesity medicationsCardiorespiratory fitnessHeart failureHFpEFObesityObesity paradox

Identifiers

PMID41400711
PMCPMC12708749

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.