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We appreciate Dr. Cheng's comments, and we agree that Hippocrates recognized the association between obesity and cardiovascular disease and that his famous quotation is not a paradox. In the title of our editorial (1), we placed the question mark to emphasize that we were questioning this paradox. More importantly, however, we were trying to use Hippocrates' quotation as a “catchy” introduction to the puzzling “obesity paradox,” meaning that, although obesity contributes to the development of several cardiovascular diseases (hypertension, heart failure, and coronary artery disease), in many situations as discussed in our editorial (1), paradoxically the prognosis of the obese patient with the disease has been better than that in the leaner patients with the same disease (2,3). We agree with Dr. Cheng's comments on the accurate meaning of the word “paradox” and the errors frequently made using this term, and we appreciate his attention to detail. Likewise, we also enjoyed reading the additional words from Hippocrates relating to the perils of obesity.
- American College of Cardiology Foundation