The obesity conundrum in sepsis

While the long-term negative effects of obesity on health is a well-studied phenomenon, its effects on acute illnesses seem to be the contrary. Several studies have indicated the possibility of an ‘obesity paradox’ in sepsis – where overweight and obese patients have better outcomes than normal weight patients. These meta-analyses including large numbers of patients across different countries raised an interesting but debatable topic. Results from meta-analyses of observational studies should be interpreted with caution, and a prove of association not be mistaken as prove of causality. Limitations common to such studies include inadequate adjustment for confounding and selection bias. More rigorous investigations to clarify any causal relationship between obesity and mortality in sepsis are needed.