The Toll of Untreated Obesity on Global Heart Disease

Big change creeps up on us. Is the American Heart Association moving away from implicit bias that obesity is a simple matter of bad behavior? Reading a new scientific statement from AHA, it seems like it. In fact, this statement makes it plain right up front. “Obesity is a multifactorial disease” is how it opens. Then it goes on to document how untreated obesity contributes to the global burden of heart disease.

Tiffany Powell-Wiley explains the importance:

“This scientific statement provides the most recent research and information on the relationship between obesity and obesity treatment in coronary heart disease, heart failure and arrhythmias. The timing of this information is important because the obesity epidemic contributes significantly to the global burden of cardiovascular disease and numerous chronic health conditions that also impact heart disease.”

The Need for Better Treatment and Prevention

This position paper makes the need for better treatment and prevention perfectly clear in its concluding words:

“The dramatic increase in the proportion of young patients with severe obesity invokes the need for more upstream interventions for the primary prevention and better treatment of obesity as a chronic disease.”

Persistent, Severe Obesity

A new study in BMC Public Health makes this picture unmistakeable. Barbara Iyen and colleagues followed 264,230 persons with excess weight and obesity for more than a decade. In every weight category, the progression of BMI was steady and upward. For people with severe obesity (class 3), the toll on heart health was great. Mortality from heart disease tripled. So too did the risk of heart failure.

Current approaches to obesity rely mostly on ineffective self-help strategies. Access to real medical obesity care is poor. At the same time, prevention programs have been largely ineffective to date. Iyen explains:

“We have found that despite widespread efforts to prevent and manage obesity, the majority of adults who are overweight or obese in the general population continue to remain so in the long term. More effective policies and weight-management interventions are needed urgently to address this increasing burden and associated adverse health outcomes.”

An End to Reliance on Ineffective Measures

Our abiding hope is that health policy on obesity will move in a new direction. Because the toll of asking people to reverse this disease mainly through self-help has become too great to bear. Prevention programs that “ought to work” are just not good enough.

We need access to real medical care for obesity. Not endless hoop jumping and box ticking. It’s disgusting that health insurance can deny coverage for obesity treatment “regardless of medical need.”

Likewise we need prevention strategies that actually bend the curve of growing obesity prevalence. Not just programs that sound good and signal our virtue. Surely the time has come to move in a smarter direction on obesity.

Click here for the new AHA paper and here for further perspective. For the study in BMC Public Health, click here and then here for further perspective.

The Heart Goes from Sugar to Coffee, watercolor by Kurt Schwitters / WikiArt

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April 27, 2021