The DOI matches its Crossref record; 79 of the 79 references it cites were found in a registry or an index.
Implementation of Obesity Science Into Clinical Practice: A Scientific Statement From the American Heart Association
Open accessAbstract
Obesity is a recognized public health epidemic with a prevalence that continues to increase dramatically in nearly all populations, impeding progress in reducing incidence rates of cardiovascular disease. Over the past decade, obesity science has evolved to improve knowledge of its multifactorial causes, identifying important biological causes and sociological determinants of obesity. Treatments for obesity have also continued to develop, with more evidence-based programs for lifestyle modification, new pharmacotherapies, and robust data to support bariatric surgery. Despite these advancements, there continues to be a substantial gap between the scientific evidence and the implementation of research into clinical practice for effective obesity management. Addressing barriers to obesity science implementation requires adopting feasible methodologies and targeting multiple levels (eg, clinician, community, system, policy) to facilitate the delivery of obesity-targeted therapies and maximize the effectiveness of guideline-driven care to at-need patient populations. This scientific statement (1) describes strategies shown to be effective or promising for enhancing translation and clinical application of obesity-based research; (2) identifies key gaps in the implementation of obesity science into clinical practice; and (3) provides guidance and resources for health care professionals, health care systems, and other stakeholders to promote broader implementation and uptake of obesity science for improved population-level obesity management. In addition, advances in implementation science that hold promise to bridge the know-do gap in obesity prevention and treatment are discussed. Last, this scientific statement highlights implications for health research policy and future research to improve patient care models and optimize the delivery and sustainability of equitable obesity-related care.
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The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Using both BMI and waist circumference provides complementary prognostic information regarding risk for future metabolic derangements, incident CVD, and mortality.”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [29]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“There are, however, many published qualitative systematic reviews and meta-analyses on this topic.25–29”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [29]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Weight management has myriad benefits in T2D, including reductions of A1C and hepatic steatosis, and improvement in cardiovascular risk factors.26,29”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [29]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Adverse CKM risk factor levels (overweight/obesity, hypertension, hypertriglyceridemia, diabetes, CKD) during the prepregnancy period are associated with increased risk of APOs.18,29”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [29]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“While waist-hip ratio provides improved characterization of metabolic and cardiovascular risk than waist circumference, challenges of complexity of measurement and lack of standardization make it less ideal for use in clinical settings.18,29–32”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [29]
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“Fortunately, GLP-1–based therapy has been shown to mitigate postsurgical weight regain in several observational studies.10–12,29”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [29]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
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“Studies examining the cost-effectiveness of adding SGLT2i to prior standard care in patients with diabetes found that, from a US health care sector perspective, this approach is projected to be cost-effective compared with standard therapy.”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [29]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“A high-quality modeling study examining the cost-effectiveness of dapagliflozin in nondiabetic CKD found that dapagliflozin improved life expectancy by 2 years, increased discounted QALY (from 6.75 to 8.06), and reduced incident kidney failure requiring kidney replacement therapy over the lifetime of the cohort.”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [29]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“While these trials did not recruit patients with pre-HF or analyze this subgroup, post-hoc biomarker substudies of these trials suggested a high median NT-proBNP and hs-cTn, with >50% of the trial population demonstrating biomarker levels consistent with pre-HF.27–30”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [29]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“The UK HARP 3 (UK Heart and Renal Protection III) trial in patients with CKD demonstrated no significant difference between the kidney effects of ARNI and ARB, although only a small proportion of participants had HF.29”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [29]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Data from meta-analyses and pooled studies demonstrate that individuals at highest risk for MASLD and its progression include those with T2D and/or those with more than 2 cardiometabolic risk factors such as obesity, hyperlipidemia, or hypertension.14,28–30”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [29]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Using data from the National Health and Nutrition Examination Survey (NHANES) III, MASLD prevalence and severity increased with a higher number of metabolic comorbidities, particularly in persons with T2D, and those with MASLD and T2D had the highest risk of mortality.29,30”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [29]
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Citations
Cites
Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association
Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Alonso, A., Beaton, A. Z., Bittencourt, M. S., Boehme, A. K., Buxton, A. E., Carson, A. P., Commodore-Mensah, Y., et al. (2022) · Circulation · doi:10.1161/cir.0000000000001052 · Cited by 5,987
Tirzepatide Once Weekly for the Treatment of Obesity
Jastreboff, A. M., Aronne, L. J., Ahmad, N. N., Wharton, S., Connery, L., Alves, B., Kiyosue, A., Zhang, S., Liu, B., Bunck, M. C., et al. (2022) · New England Journal of Medicine · doi:10.1056/nejmoa2206038 · Cited by 3,838 · cited 1×
“31a However, obesity pharma-cotherapies continue to be dramatically underprescribed.”
BackgroundObesity and cardiovascular disease: a scientific statement from the American Heart Association
Powell-Wiley, T. M., Poirier, P., Burke, L. E., Després, J.-P., Gordon-Larsen, P., Lavie, C. J., Lear, S. A., Ndumele, C. E., Neeland, I. J., Sanders, P., et al. (2021) · Circulation · doi:10.1161/cir.0000000000000973 · Cited by 3,691
Self-citationSemaglutide and Cardiovascular Outcomes in Obesity without Diabetes
Lincoff, A. M., Brown-Frandsen, K., Colhoun, H. M., Deanfield, J., Emerson, S. S., Esbjerg, S., Hardt-Lindberg, S., Hovingh, G. K., Kahn, S. E., Kushner, R. F., et al. (2023) · New England Journal of Medicine · doi:10.1056/nejmoa2307563 · Cited by 3,236
Lloyd-Jones, D. M., Allen, N. B., Anderson, C. A. M., Black, T., Brewer, L. C., Foraker, R. E., Grandner, M. A., Lavretsky, H., Perak, A. M., Sharma, G., et al. (2022) · Circulation · doi:10.1161/cir.0000000000001078 · Cited by 2,785
Obesity Phenotypes, Diabetes, and Cardiovascular Diseases
Piché, M., Tchernof, A., & Després, J. (2020) · Circulation Research · doi:10.1161/circresaha.120.316101 · Cited by 2,133 · cited 3×
“Moreover, the lack of consensus on appropriate clinical parameters or quality benchmarks to define obesity-related outcomes (given its heterogeneity) 24 that qualify for reimbursement further adds to clinician frustrations and thwarts implementation of obesity management programs.”
BackgroundProjected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity
Ward, Z. J., Bleich, S. N., Cradock, A. L., Barrett, J. L., Giles, C. M., Flax, C., Long, M. W., & Gortmaker, S. L. (2019) · New England Journal of Medicine · doi:10.1056/nejmsa1909301 · Cited by 2,009 · cited 1×
“4–6 Over the past decade, significant progress made in obesity science has contributed to the discovery of knowledge cutting across the domains of basic, translational, and biobehavioral science; epidemiology; and clinical studies/trials.”
BackgroundBridging Research and Practice
Tabak, R. G., Khoong, E. C., Chambers, D. A., & Brownson, R. C. (2012) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2012.05.024 · Cited by 1,386 · cited 1×
“7–9 These gaps are sustained by structural, societal, and cultural barriers that are pervasive in real-world clinical practice and require a redoubling of efforts and alternative strategies for resolution and advancement.”
BackgroundBenefits and Risks of Bariatric Surgery in Adults: A Review
Arterburn, D. E., Telem, D. A., Kushner, R. F., & Courcoulas, A. P. (2020) · JAMA · doi:10.1001/jama.2020.12567 · Cited by 1,251 · cited 2×
“40,42,43 Although structural factors that unfairly limit access to surgery account for some of the inequities, additional reasons include the perception and reality that the social supports needed for surgery to be successful are absent in underresourced populations with the greatest needs.”
BackgroundCarnethon, M. R., Pu, J., Howard, G., Albert, M. A., Anderson, C. A. M., Bertoni, A. G., Mujahid, M. S., Palaniappan, L., Taylor, H. A., Willis, M., et al. (2017) · Circulation · doi:10.1161/cir.0000000000000534 · Cited by 1,147
Self-citation
Flagged first, then by citations
Research works printed but not linked: 1
- National Academies of Sciences Engineering and Medicine. Roundtable on Obesity Solutions: Year in Review 2022. Accessed August 3 2023. https://nap.nationalacademies.org/catalog/26855/roundtable-on-obesity-solutions-year-in-review-2022
Cited by
Sorted by citations
Zhou, X., Chen, Q., Yang, W., Zuluaga, M., Targher, G., Byrne, C. D., Valenti, L. V. C., Luo, F., Katsouras, C. S., Thaher, O., et al. (2024) · EClinicalMedicine · doi:10.1016/j.eclinm.2024.102848 · Cited by 269
Ndumele, C. E., Rodríguez, F., Dixon, D. L., Khan, S. S., Mukherjee, D., Bajaj, M. S., Bangalore, S., Bozkurt, B., Breathett, K. K., Clarke, S. L., et al. (2026) · Circulation · doi:10.1161/cir.0000000000001453 · Cited by 101
Self-citationNdumele, C. E., Rodriguez, F., Dixon, D. L., Khan, S. S., Mukherjee, D., Bajaj, M., Bangalore, S., Bozkurt, B., Breathett, K., Clarke, S. L., et al. (2026) · JACC · doi:10.1016/j.jacc.2026.03.056 · Cited by 90
Self-citationCarbone, F., Després, J., Ioannidis, J. P. A., Neeland, I. J., Garruti, G., Busetto, L., Liberale, L., Ministrini, S., Vilahur, G., Schindler, T. H., et al. (2025) · European Journal of Clinical Investigation · doi:10.1111/eci.70059 · Cited by 46
Self-citationAyesh, H., Nasser, S. A., Ferdinand, K. C., & Leon, B. G. C. (2025) · Circulation Research · doi:10.1161/circresaha.124.325535 · Cited by 42
Metadata
- Authors
- Laddu, D., Neeland, I. J., Carnethon, M., Stanford, F. C., Mongraw-Chaffin, M., Barone Gibbs, B., Ndumele, C. E., Longenecker, C. T., Chung, M. L., Rao, G., & on behalf of the American Heart Association Obesity Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Epidemiology and Prevention; Council on Clinical Cardiology; Council on Hypertension; Council on the Kidney in Cardiovascular Disease; and Council on Cardiovascular and Stroke Nursing
- ORCID
- Venue
- Circulation
- Published
- 2024-07-02
- Volume
- 150
- Issue
- 1
- Pages
- e7-e19
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC11416804
- OpenAlex
- W4398144590
- Semantic Scholar
- 621886cfd30e421d9937d5cc151dd8bbce9cc20d
- Cited by
- 62
- References
- 79
- Citations by year
- 2026: 37 · 2025: 18 · 2024: 7
- FWCI
- 5.57
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- American Heart Association
- Office of Science
- National Heart, Lung, and Blood Institute (K01HL148503)
- National Institute of Nursing Research (R01NR019456)
- National Institute of Diabetes and Digestive and Kidney Diseases (U24DK132733, UE5DK137285)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity and Health Practices
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- obesity, implementation science, clinical translation, obesity treatment, lifestyle modification, obesity pharmacotherapy, bariatric surgery, cardiovascular disease, health policy, health equity, implementation barriers, obesity prevention
- MeSH terms
- American Heart Association, Humans, Obesity, United States
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