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The Critical Care Commute Podcast · Nov 12, 2025 · 18 min

The Obesity Paradox with Dr Rob Bevan

In this episode, Peter Brindley interviews Dr. Rob Bevan, past president of the CICM, about the obesity paradox in Intensive Care Units (ICUs). They discuss the surprising observation that overweight ICU patients often show better survival rates than those underweight, despite obesity's known health risks. Dr. Bevan dives into the history and the limitations of BMI as a metric and various biases that could influence the perceived obesity paradox. He also explains how classification bias, selection bias, confounding, and collider bias might skew these outcomes. The discussion touches on the importance of separating patients who are critically ill and happen to be obese from those who are in ICU primarily because of obesity-related diseases. The conversation is rooted in the upcoming textbook chapter authored by Dr. Bevan and explores obesity's broader health implications globally.

0:00-18:27

transcript

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show notes

In this episode, Peter Brindley interviews Dr. Rob Bevan, past president of the CICM, about the obesity paradox in Intensive Care Units (ICUs).

They discuss the surprising observation that overweight ICU patients often show better survival rates than those underweight, despite obesity's known health risks. Dr. Bevan dives into the history and the limitations of BMI as a metric and various biases that could influence the perceived obesity paradox. He also explains how classification bias, selection bias, confounding, and collider bias might skew these outcomes. The discussion touches on the importance of separating patients who are critically ill and happen to be obese from those who are in ICU primarily because of obesity-related diseases. The conversation is rooted in the upcoming textbook chapter authored by Dr. Bevan and explores obesity's broader health implications globally.