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Updated: Aug 4, 2025

Multidisciplinary Approach to Obesity Management: A Case Report
05:10

Multidisciplinary Approach to Obesity Management: A Case Report

Published on: May 30, 2025

247

How cardiologists can manage excess body weight and related cardiovascular risk. An expert opinion

Massimo Volpe1, Claudio Borghi2, Matteo Cameli3

  • 1Department of Clinical and Molecular Medicine, University of Rome Sapienza and IRCCS San Raffaele - Roma, Italy.

International Journal of Cardiology
|March 31, 2023
PubMed

Insights

Obesity is a chronic inflammatory disease and a cardiovascular risk factor. Weight loss interventions, including semaglutide, show promise in reducing major adverse cardiac events in obese patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Public Health

Background:

  • Obesity is a significant independent cardiovascular risk factor and a chronic inflammatory condition.
  • Elevated Body Mass Index (BMI) >27 kg/m2 is linked to increased risk of Major Adverse Cardiac Events (MACE).
  • Weight reduction offers substantial benefits in mitigating metabolic, cardiovascular, and oncological risks.

Purpose of the Study:

  • To address the knowledge gap regarding the cardiovascular outcomes of weight loss pharmacotherapies in obese patients.
  • To highlight the ongoing SELECT trial investigating semaglutide's efficacy in reducing MACE in patients with obesity and cardiovascular disease.
  • To advocate for recognizing obesity as a complex chronic disease and improving its management, emphasizing the role of cardiologists.

Main Methods:

  • Review of existing literature on obesity, cardiovascular risk, and weight loss pharmacotherapies.
  • Discussion of randomized clinical trials (RCTs) evaluating treatments like liraglutide and semaglutide in diabetic populations.
  • Focus on the design and primary endpoint (MACE) of the ongoing SELECT trial for obese patients with cardiovascular disease.

Main Results:

  • Pharmacotherapies such as orlistat, bupropion/naltrexone, liraglutide, and semaglutide, alongside lifestyle changes, are effective for weight loss.
  • Liraglutide and semaglutide have demonstrated cardiovascular outcome benefits primarily in diabetic patients, not specifically in obese populations.
  • The SELECT trial is crucial for evaluating semaglutide's impact on MACE in obese individuals with existing cardiovascular disease.

Conclusions:

  • Obesity requires a paradigm shift towards its recognition as a complex chronic disease, combating associated stigma.
  • Effective management strategies for obesity are essential, necessitating a global approach involving healthcare professionals, particularly cardiologists.
  • Further research, exemplified by the SELECT trial, is vital to understand and optimize cardiovascular risk reduction in obese patients through pharmacotherapy.

Keywords:
Cardiovascular riskClinical frameworkObesityTreatment

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