Obesity and cardiovascular disease: mechanistic insights and management strategies. A joint position paper by the World Heart Federation and World Obesity Federation
Open accessAbstract
The ongoing obesity epidemic represents a global public health crisis that contributes to poor health outcomes, reduced quality of life, and >2.8 million deaths each year. Obesity is relapsing, progressive, and heterogeneous. It is considered a chronic disease by the World Obesity Federation (WOF) and a chronic condition by the World Heart Federation (WHF). People living with overweight/obesity are at greater risk for cardiovascular (CV) morbidity and mortality. Increased adiposity (body fat), particularly visceral/abdominal fat, is linked to CV risk and CV disease (CVD) via multiple direct and indirect pathophysiological mechanisms. The development of CVD is driven, in part, by obesity-related metabolic, endocrinologic, immunologic, structural, humoral, haemodynamic, and functional alterations. The complex multifaceted nature of these mechanisms can be challenging to understand and address in clinical practice. People living with obesity and CVD often have concurrent chronic physical or psychological disorders (multimorbidity) requiring multidisciplinary care pathways and polypharmacy. Evidence indicates that intentional weight loss (particularly when substantial) lowers CVD risk among people with overweight/obesity. Long-term weight loss and maintenance require ongoing commitment from both the individual and those responsible for their care. This position paper, developed by the WOF and the WHF, aims to improve understanding of the direct and indirect links between overweight/obesity and CVD, the key controversies in this area and evidence relating to cardiometabolic outcomes with available weight management options. Finally, an action plan for clinicians provides recommendations to help in identifying and addressing the risks of obesity-related CVD (recognizing resource and support variances between countries).
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More substantial weight reduction in individuals with overweight or obesity is associated with a decreased CVD risk.
“It has been shown that more substantial weight reduction in individuals with overweight or obesity is associated with a decreased CVD risk.26”
From Tirzepatide compared with semaglutide and 10-year cardiovascular disease risk reduction in obesity: <i>post-hoc</i> analysis of the SURMOUNT-5 trial (2025) · cites this paper as [26]
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- Authors
- Lopez-Jimenez, F., Almahmeed, W., Bays, H., Cuevas, A., Di Angelantonio, E., le Roux, C. W., Sattar, N., Sun, M. C., Wittert, G., Pinto, F. J., & Wilding, J. P. H.
- Affiliations
- Department of Cardiovascular Medicine, Mayo Clinic , Rochester, MN , USA
- Cleveland Clinic Abu Dhabi (AE)
- Louisville Metabolic and Atherosclerosis Research Center (US)
- Finis Terrae University (CL)
- Department of Public Health and Primary Care, University of Cambridge , Cambridge , UK
- Diabetes Complications Research Centre, University College Dublin , Dublin , Ireland
- University of Glasgow (GB)
- University of Mauritius (MU)
- Freemasons Foundation Centre for Men's Health (AU)
- University of Lisbon (PT)
- Aintree University Hospital (GB)
- ORCID
- Venue
- European Journal of Preventive Cardiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2022-08-25
- Volume
- 29
- Issue
- 17
- Pages
- 2218-2237
- ISSN
- 2047-4873 (ISSN-L)
- 2047-4881
- OpenAlex
- W4293243052
- Cited by
- 362
- References
- 31
- Citations by year
- 2026: 82 · 2025: 133 · 2024: 94 · 2023: 49 · 2022: 4
- FWCI
- 48.75
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- European Journal of Preventive Cardiology (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion, cc-by-sa)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
- Funders
- Novo Nordisk
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- 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
- Keywords
- obesity, cardiovascular disease, visceral fat, weight loss, weight management, multimorbidity, obesity as chronic disease, cardiovascular risk factors, clinical guidelines
- MeSH terms
- Cardiovascular Diseases, Humans, Obesity, Quality of Life, Weight Loss
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