Weight Management and Cardiovascular Disease
Weight Management and Cardiovascular Disease
Obesity is a global issue with increasing evidence that overweight and obesity are associated with a higher chronic disease risk. Despite over 10 years of government recognition of a need to develop and implement effective prevention strategies, all age groups are getting fatter with overweight becoming the 'norm'. Modest weight loss reduces many of the risk factors that accompany obesity, notably type 2 diabetes, hypertension and dyslipidaemia. Adherence to lifestyle changes required to achieve these improvements is poor and progressively more weight-loss medications are used as adjunctive therapy, while bariatric surgery is performed for the severely obese.
Currently available pharmacotherapy shows encouraging benefits in clinical trials but remains unproven as an effective strategy to support long-term weight loss and weight maintenance and for translation of improved surrogate risk markers into fewer cardiovascular events and a longer life. Three large clinical trials are ongoing in an attempt to answer this question.
Increased weight causes or exacerbates a large number of health problems, among which cardiovascular disease is perhaps the most important. Life insurance data and epidemiological studies have shown that increasing degrees of overweight (defined as a BMI ≥ 25 kg/m) and obesity (BMI ≥ 30 kg/m) are important predictors of reduced life expectancy. Compared with normal-weight 40-year-old individuals, being obese reduces the life expectancy of a 40-year-old non-smoker without previously diagnosed cardiovascular disease by 7 years for women and 6 years for men.
Nevertheless, we are getting fatter as a nation. Data from the Health Survey for England, 2005 show that 24.3% of women and 22.1% of men are obese, and that it is now ‘normal’ to be overweight. Rates of obesity have increased by 30% in women, 40% in men, and 50% in children over the past decade, despite 10 years or more of recognition by government of a need to develop and implement effective prevention strategies. The problem is not confined to the UK with increasing obesity prevalence recorded worldwide. The complexities of preventing, let alone treating obesity, however, were highlighted in the recent Foresight report with the implication that intervention and pharmacotherapy will be increasingly necessary. Data issued by the NHS Information Centre confirm that there has been a rise in the number of items prescribed to treat obesity in England from 127,000 in 1999 to 1.06 million in 2006.
Abstract and Introduction
Abstract
Obesity is a global issue with increasing evidence that overweight and obesity are associated with a higher chronic disease risk. Despite over 10 years of government recognition of a need to develop and implement effective prevention strategies, all age groups are getting fatter with overweight becoming the 'norm'. Modest weight loss reduces many of the risk factors that accompany obesity, notably type 2 diabetes, hypertension and dyslipidaemia. Adherence to lifestyle changes required to achieve these improvements is poor and progressively more weight-loss medications are used as adjunctive therapy, while bariatric surgery is performed for the severely obese.
Currently available pharmacotherapy shows encouraging benefits in clinical trials but remains unproven as an effective strategy to support long-term weight loss and weight maintenance and for translation of improved surrogate risk markers into fewer cardiovascular events and a longer life. Three large clinical trials are ongoing in an attempt to answer this question.
Introduction
Increased weight causes or exacerbates a large number of health problems, among which cardiovascular disease is perhaps the most important. Life insurance data and epidemiological studies have shown that increasing degrees of overweight (defined as a BMI ≥ 25 kg/m) and obesity (BMI ≥ 30 kg/m) are important predictors of reduced life expectancy. Compared with normal-weight 40-year-old individuals, being obese reduces the life expectancy of a 40-year-old non-smoker without previously diagnosed cardiovascular disease by 7 years for women and 6 years for men.
Nevertheless, we are getting fatter as a nation. Data from the Health Survey for England, 2005 show that 24.3% of women and 22.1% of men are obese, and that it is now ‘normal’ to be overweight. Rates of obesity have increased by 30% in women, 40% in men, and 50% in children over the past decade, despite 10 years or more of recognition by government of a need to develop and implement effective prevention strategies. The problem is not confined to the UK with increasing obesity prevalence recorded worldwide. The complexities of preventing, let alone treating obesity, however, were highlighted in the recent Foresight report with the implication that intervention and pharmacotherapy will be increasingly necessary. Data issued by the NHS Information Centre confirm that there has been a rise in the number of items prescribed to treat obesity in England from 127,000 in 1999 to 1.06 million in 2006.