Obesity and cardiovascular disease: weight loss is not the only target

Although obesity is generally perceived as causing prejudice to heart health, there is considerable individual metabolic heterogeneity among equally overweight or obese individuals. Such heterogeneity suggests that several factors can modulate health risk at any given body weight. In the present article, the thesis that weight loss and achieving a healthy body weight through caloric restriction might not represent optimal clinical and public health messages to combat the current obesity epidemic is defended. Rather, it is proposed that reducing waist circumference and increasing cardiorespiratory fitness through improving nutritional quality, reducing sedentary behaviours, and increasing participation to physical activity/exercise might be associated with clinical benefits, sometimes even in the absence of weight loss.