Management of Obesity in Cardiovascular Practice
Open accessAbstract
Obesity contributes to reduced life expectancy because of its link with type 2 diabetes and cardiovascular disease. Yet, targeting this poorly diagnosed, ill-defined, and underaddressed modifiable risk factor remains a challenge. In this review, we emphasize that the tendency among health care professionals to amalgam all forms of obesity altogether as a single entity may contribute to such difficulties and discrepancies. Obesity is a heterogeneous condition both in terms of causes and health consequences. Attention should be given to 2 prevalent subgroups of individuals: 1) patients who are overweight or moderately obese with excess visceral adipose tissue; and 2) patients with severe obesity, the latter group having distinct additional health issues related to their large body fat mass. The challenge of tackling high-cardiovascular-risk forms of obesity through a combination of personalized clinical approaches and population-based solutions is compounded by the current obesogenic environment and economy.
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The study's scale and duration, and inclusion of patients with a broad range of BMIs, represent most patients seen in a typical cardiovascular practice.
“Strengths of our study include its scale and duration, as well as the inclusion of patients with a broad range of BMIs, representing most patients seen in a typical cardiovascular practice.23”
From Semaglutide and cardiovascular outcomes by baseline and changes in adiposity measurements: a prespecified analysis of the SELECT trial (2025) · cites this paper as [23]
The Abstract discusses overweight, moderate obesity, and severe obesity, and the section on severe obesity says patients with BMI ≥35 kg/m² are common in daily cardiology practice. The review does not assess the citing authors’ study or establish that its BMI range represents most patients in a typical cardiovascular practice. The study’s scale and duration are the citing authors’ own description, not a finding attributed to this source. (LLM, conf=0.82)
Experimental — accuracy not yet measuredOverall diet quality and physical activity or fitness level are potent modulators of the risk associated with any BMI value, regardless of body composition.
“Furthermore, overall diet quality and physical activity or fitness level are potent modulators of the risk associated with any BMI value, regardless of body composition.44”
From Definition and diagnostic criteria of clinical obesity (2025) · cites this paper as [44]
The section 'Lifestyle and prevention/remission of T2D in visceral obesity' (page unavailable) links healthier diets and physical activity to lower cardiovascular risk and identifies fitness as a powerful risk predictor. 'From obesity to obesities' (page unavailable) also describes risk variation within BMI categories. The paper does not establish that these factors modulate risk at any BMI regardless of body composition; it emphasizes visceral adiposity as an important source of risk variation. (LLM, conf=0.84)
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- Authors
- Després, J.-P., Carpentier, A. C., Tchernof, A., Neeland, I. J., & Poirier, P.
- Affiliations
- Institut universitaire de cardiologie et de pneumologie de Québec (CA)
- Université de Sherbrooke (CA)
- University Hospitals of Cleveland (US)
- Corresponding author
- Després, Jean-Pierre
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2021-08
- Volume
- 78
- Issue
- 5
- Pages
- 513-531
- ISSN
- 0735-1097 (ISSN-L)
- PMC
- PMC8609918
- OpenAlex
- W3186621629
- Cited by
- 87
- References
- 159
- Citations by year
- 2026: 18 · 2025: 19 · 2024: 16 · 2023: 18 · 2022: 13 · 2021: 3
- FWCI
- 1.92
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Canadian Institutes of Health Research (FDN- 167278)
- National Institute of Diabetes and Digestive and Kidney Diseases (K23DK106520)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Keywords
- obesity, cardiovascular risk, type 2 diabetes, visceral adipose tissue, morbid obesity, obesity heterogeneity, obesity treatment, obesogenic environment, modifiable risk factors, individualized care, population-level interventions
- MeSH terms
- Cardiology, Cardiovascular Diseases, Humans, Obesity
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