Obesity is a heterogeneous condition and the prevalence is increasing globally, according to a review published July 26 in the Journal of the American College of Cardiology. As part of managing obesity, attention should be given to two main subgroups: overweight or moderately obese patients with an excess of visceral adipose tissue (VAT) and severely obese patients.

Jean-Pierre Després, CQ, PhD, et al., review population-based solutions and clinical approaches for obesity management and assess the challenges presented by today’s economy and obesogenic environment. According to the authors, obesity is connected to type 2 diabetes and cardiovascular disease, and this association could reduce life expectancy.

The authors note that when treating obesity, there are two subgroups of patients that should take priority. The first subgroup includes patients with excess VAT who are either overweight or moderately obese. The second group contains patients who are severely obese, and this subgroup often suffers from additional health concerns due to their large body fat mass.

“Among overweight and moderately obese patients, excess VAT accumulation and deposition of fat in undesired sites are key drivers of unfavorable health outcomes, irrespective of the patient’s body weight,” the authors explain. “Severe obesity must also be recognized because it is associated with important health issues, and dealing with this high-risk obesity phenotype is required in terms of health risk and clinical management.” 

The review also highlighted that health risks can be determined by analyzing individual variations in regional body fat distributions, and that patients with excess visceral fat often contain additional fat in the heart, kidneys, liver, pancreas and skeletal muscle. In addition, elevated waist circumference should be routinely monitored due to its association with health hazards. Further, even without weight loss, interventions that target waist circumference reduction benefit patients at cardiovascular risk.

Després et al., conclude that moving forward, “cardiologists must play an important leadership role in recommending the development of multidisciplinary clinical teams … as well as the implementation of the public health policies required to have a long-term impact on the socioeconomic causes of obesity.”

Keywords: Intra-Abdominal Fat, Waist Circumference, Weight Loss, Obesity, Morbid, Diabetes Mellitus, Type 2, Obesity, Overweight, Body Fat Distribution, Liver, Muscle, Skeletal, Cardiology, Pancreas, Kidney, Health Policy, Socioeconomic Factors

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