From the Guidelines
Morbid obesity is associated with a significantly higher risk of cardiovascular disease, morbidity, and mortality, with a competing hazard ratio of 3.14 for men and 2.53 for women, and is also linked to a shorter overall lifespan. The effects of morbid obesity are multifaceted, impacting not only cardiovascular health but also overall quality of life. According to the 2024 ESC guidelines for the management of chronic coronary syndromes 1, morbid obesity (BMI of ≥40.0 kg/m2) is associated with a higher lifetime risk of incident cardiovascular disease (CVD) and cardiovascular morbidity and mortality compared to those with a normal BMI.
Key Findings
- Morbid obesity is linked to an increased risk of CVD, with competing hazard ratios of 3.14 for men and 2.53 for women 1.
- Obesity is associated with a shorter overall lifespan, and being overweight is associated with developing CVD at an earlier age 1.
- Intentional weight loss is associated with a significantly lower risk of adverse clinical outcomes, and has beneficial effects on risk-factor control and quality of life (QoL) 1.
- Healthy diets with energy intake limited to the amount needed to obtain and maintain a healthy weight, combined with increasing physical activity, are recommended for weight management 1.
Treatment Options
- GLP-1 receptor agonists, such as semaglutide and tirzepatide, are effective for weight loss and have been shown to reduce the incidence of cardiovascular death, MI, or stroke 1.
- Bariatric surgery is a safe and effective intervention for further weight loss in patients with severe obesity 1.
- Cardiac rehabilitation programs should include weight-loss interventions to reach a healthy weight as a specific component 1.
- A review of obesity management in adults highlights the importance of comprehensive, evidence-based treatment combining behavioral interventions, nutrition, physical activity, pharmacotherapy, and metabolic/bariatric procedures as appropriate for individual patients 1.
From the Research
Effects of Morbid Obesity
The effects of morbid (Mx) obesity are not directly addressed in the provided studies. However, the studies discuss the treatment and management of obesity, which can be related to the effects of morbid obesity.
Treatment and Management of Obesity
- Lifestyle changes, including diet and increased physical activity, are foundational to any weight loss effort 2, 3, 4, 5, 6
- Pharmacological approaches, such as orlistat, naltrexone/bupropion, and liraglutide, can be used as adjunct therapy to lifestyle modifications 2, 3, 5, 6
- Surgical management, including gastric banding, sleeve gastrectomy, and Roux-en Y gastric bypass, can produce remarkable health improvement and reduce mortality for patients with severe obesity 2, 4
Health Implications of Obesity
- Obesity is a chronic, complex, and heterogeneous disease influenced by genetic, developmental, biological, and environmental factors 3, 5, 6
- Obesity is among the leading causes of morbidity and mortality worldwide, and its prevalence continues to increase globally 3, 5, 6
- Obesity can lead to other chronic conditions and related morbidity and mortality 6