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Multidisciplinary Approach to Obesity Management: A Case Report
Published on: May 30, 2025
Value of weight reduction in patients with cardiovascular disease
Surya M Artham1, Carl J Lavie, Richard V Milani
1Ochsner Medical Center, 1514 Jefferson Highway, New Orleans, LA, 70121, USA.
Insights
Obesity significantly increases cardiovascular disease risk. This review covers exercise, medications, and surgery for obesity treatment and their cardiovascular benefits.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- Obesity (BMI ≥30 kg/m²) is a major independent risk factor for cardiovascular (CV) disease.
- It exacerbates conditions like hypertension, diabetes mellitus, and dyslipidemia.
- Severe obesity (BMI ≥35 kg/m²) is linked to higher morbidity and mortality.
Purpose of the Study:
- To review the obesity epidemic and its adverse effects on the cardiovascular system.
- To discuss current and emerging therapeutic strategies for obesity management.
- To evaluate the CV benefits and risks of pharmacologic and surgical interventions.
Main Methods:
- Review of existing literature on obesity and cardiovascular health.
- Analysis of exercise training protocols for weight management.
- Examination of established and novel pharmacologic agents for obesity.
- Evaluation of bariatric surgery outcomes and CV impact.
Main Results:
- Physical activity, diet, and behavioral changes are foundational obesity treatments.
- Limited pharmacologic options currently exist with proven efficacy and safety.
- Bariatric surgery demonstrates significant CV benefits for select patients.
Conclusions:
- Obesity poses a substantial threat to cardiovascular health.
- A multi-faceted approach including lifestyle, pharmacotherapy, and surgery is crucial.
- Careful consideration of risks and benefits is essential for pharmacologic and surgical obesity treatments.
Opinion Statement:
Obesity is an independent risk factor for cardiovascular (CV) disease and contributes markedly to individual CV risk factors, including hypertension, diabetes mellitus, dyslipidemia, and other chronic conditions, such as osteoarthritis, obstructive sleep apnea, and physical deconditioning. Obesity, defined as a body mass index ≥30 kg/m(2), is associated with increased morbidity and mortality, particularly in severely obese patients with a body mass index ≥35 kg/m(2). Physical activity, healthy eating and behavioral modification are three pivotal approaches to treating obesity. Some individuals may benefit from pharmacologic agents to achieve meaningful weight loss. Unfortunately, there are few such agents at present with proven efficacy and safety profiles. In this review, we discuss the obesity epidemic and its detrimental effects on the CV system, and focus on exercise training and on established pharmacologic agents as well as those on the horizon. We conclude by summarizing the surgical therapeutic options available to treat obesity and the evidence supporting the CV benefits of surgery, and discuss the potential adverse effects of both pharmacologic and surgical options.
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