In a departure from the usual advice for heart patients, a recent study suggests that carrying around a few extra pounds may actually afford some protection to heart failure (HF) patients. The study, published in the July 1 issue of the American Journal of Cardiology, raises questions about the so-called obesity paradox in heart failure, because being overweight is usually one of the main controllable risk factors heart patients are urged to address. The so-called obesity paradox in patients with heart failure suggests that those patients who are obese with higher BMIs-and particularly fat distribution in the abdomen-do better than those with more normal weights and particularly better than those who are underweight, says heart failure specialist James Young MD, Chairman of the Cleveland Clinic Endocrinology & Metabolism Institute. That paradox has been observed for some time now. It is a complicated issue.