Update on the management of obesity in cardiovascular practice
By the International Chair on Cardiometabolic Risk
On August 3, 2021, a JACC Seminar Focus on Management of Obesity in Cardiovascular Practice was published by Drs. Jean-Pierre Després, André C. Carpentier, André Tchernof, Ian J. Neeland and Paul Poirier. In this paper, the authors review the evidence that individual differences in body fat partitioning explain the heterogeneity in the cardiometabolic risk profile observed in obesity. They also point out that excess visceral adiposity is frequently associated with unwanted accumulation of lipids in normally lean tissues leading to ectopic fat deposition in the heart, the liver, the renal sinus, the pancreas and in skeletal muscles. As the authors produced this update with a clinical perspective in mind, they propose to measure waist circumference in addition to the body mass index in order to improve the discrimination of high-risk patients likely to be characterized by excessive visceral/ectopic fat deposition. They also emphasize that these viscerally obese patients at high cardiovascular risk could benefit from lifestyle interventions focussing on improving overall diet quality and physical activity/exercise even in the absence of weight loss. Under such circumstances, they propose that a reduction in waist circumference is a useful clinical marker of a loss of abdominal visceral fat. Consideration is also given in the paper to patients with severe obesity as these individuals are characterized by specific health issues related to their condition.
This JACC Seminar Focus paper provides 1 CME credit, 1 ABIM-MOC point as well as 1 ECME credit. For clinicians interested, this activity is available until July 25, 2022.