Obesity and the risk of cardiometabolic diseases

• Published in: Nature reviews cardiology Vol. 20; no. 7; pp. 475 - 494
• Main Authors: Valenzuela, Pedro L, Carrera-Bastos, Pedro, Castillo-García, Adrián, Lieberman, Daniel E, Santos-Lozano, Alejandro, Lucia, Alejandro
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 01.07.2023
• Subjects: Body Mass Index; Body Weight; Cardiovascular Diseases - complications; Cardiovascular Diseases - etiology; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi; Health Sciences; Humans; Hälsovetenskap; Medical and Health Sciences; Medicin och hälsovetenskap; Obesity; Obesity - complications; Obesity - epidemiology; Public Health, Global Health, Social Medicine and Epidemiology; Risk Factors
• ISSN: 1759-5002; 1759-5010
• DOI: 10.1038/s41569-023-00847-5

The prevalence of obesity has reached pandemic proportions, and now approximately 25% of adults in Westernized countries have obesity. Recognized as a major health concern, obesity is associated with multiple comorbidities, particularly cardiometabolic disorders. In this Review, we present obesity as an evolutionarily novel condition, summarize the epidemiological evidence on its detrimental cardiometabolic consequences and discuss the major mechanisms involved in the association between obesity and the risk of cardiometabolic diseases. We also examine the role of potential moderators of this association, with evidence for and against the so-called 'metabolically healthy obesity phenotype', the 'fatness but fitness' paradox or the 'obesity paradox'. Although maintenance of optimal cardiometabolic status should be a primary goal in individuals with obesity, losing body weight and, particularly, excess visceral adiposity seems to be necessary to minimize the risk of cardiometabolic diseases.