Josefa García Barrado
Full Professor of Pharmacology and researcher in the Neuroendocrinology and Obesity group at the University of Salamanca
What do you think of the article overall? Is it of good quality?
“This article presents a sound design for a retrospective study and is of good quality. Suffice it to say that it presents a sample size of almost one million patients, 110 surveys, and data from various countries on different continents. It is a study that covers the period from 1990 to 2024, which gives it a very broad time frame; therefore, its conclusions can be supported by the sample size without any problem.”
How does it fit with the existing evidence, and what implications might it have? Could it suggest that, with treatment, obesity is no longer a clear risk factor?
“This study doesn't offer any scientific discoveries that common sense couldn't already explain. It's logical that obese patients treated with lipid-lowering and antihypertensive drugs tend to experience a decrease in their blood pressure and lipid levels. If these results didn't follow this pattern, we would be applying ineffective pharmacological treatments and misleading the patient.
However, I think it's very important to extrapolate these results from different perspectives. On the one hand, regarding obesity: I don't believe it sends the message that obesity isn't a risk factor for many comorbidities; on the contrary, it clearly introduces this in the article's content. What is important is that it makes us reflect and helps us understand that those of us who live in industrialized countries have an effective healthcare system that cares about our well-being, which we often fail to appreciate, with access to medical treatments, specifically in our country, that are practically free. In other words, obese people in industrialized countries with available medical treatments have better quality of life and they will probably live longer. This idea is definitely worth taking to heart, to appreciate how far we've come, where we'll go, and how essential it is to sustain our system.”
Are there any significant limitations to consider?
“No, the study is well done. A comparison with developing countries would be welcome, but I suppose that would be the subject of another article.”