Review Article
Volume 7 Issue 4 - 2020
Fundamental Factors of Overweight, Obesity, and Metabolic Syndrome in Cardiovascular Disease (Key Points that Healthcare Providers, Public Health Policymakers, and the General Public Should Know about the CVD-Obesity Connection)
Nicholas A Kerna1*, Uzoamaka Nwokorie2,3, Abdullah Hafid2,3, Emmanuella Solomon2,3 and Priscilla Anusiem2,3
1SMC–Medical Research, Thailand
2University of Health and Humanities, Tortola, BVI
3University of Science, Arts and Technology, Montserrat, BWI
*Corresponding Author: Nicholas A Kerna, POB47 Phatphong, Suriwongse Road, Bangkok, Thailand 10500.
Received: March 17, 2020; Published: March 31, 2020


Overweight, obesity, and metabolic syndrome are significant risk factors in developing cardiovascular disease. It would be timeconsuming and a substantial undertaking for most healthcare practitioners (or medical students or residents), to read or review numerous articles to investigate the hallmarks of obesity and the obesity epidemic as they relate to cardiovascular disease and disorders. However, such information is invaluable in coping with cardiovascular disease (as a patient), treating heart patients (as a physician or healthcare provider), or developing public health policies (as a government official, agency, or NGO). Based on an extensive review of the literature on overweight, obesity, and metabolic syndrome, this paper acts as a review, summary, and practical resource, highlighting key points and hallmarks of these risk factors for cardiovascular disease and related disorders.

Keywords: Adiposity; Bariatric; Childhood Obesity; Diabetes; Epigenomics; Metabolic Syndrome; Overweight; Pandemic


  1. Carbone S., et al. “Obesity paradox in cardiovascular disease: where do we stand?” Vascular Health and Risk Management 15 (2019): 89-100. 
  2. Khan SS., et al. “Association of body mass index with lifetime risk of cardiovascular disease and compression of morbidity”. JAMA Cardiology 3.4 (2018): 280-287. 
  3. Health Risks of Obesity. MedicinePlus, NIH, U.S. National Library of Medicine. 
  4. Nuttall FQ. “Body Mass Index, Obesity, BMI, and Health: A Critical Review”. Nutrition Today 50.3 (2015): 117-128. 
  5. O’Neill S and O’Driscoll L. “Metabolic syndrome: A close look at the growing epidemic and its associated pathologies”. Obesity Reviews 16 (2015): 1-12. 
  6. World Health Organization (WHO) (2015). 
  7. World Resources Institute (WRI) (2015). 
  8. Jeffery RW and Utter J. “The changing environment and population obesity in the United States”. Obesity Research 11 (2003): 12S-22S.
  9. Centers for Disease Control and Prevention (CDC). Childhood overweight and obesity.[Division of Nutrition, Physical Activity, and Obesity (2015). 
  10. Ostbye T., et al. “Obesity and Workers' Compensation: Results from the Duke Health and Safety Surveillance System”. Archives of Internal Medicine 167.8 (2007): 766-773. 
  11. The Guardian. Severe obesity is a disability, European court adviser rules (2014). 
  12. McAllister EJ., et al. “Ten Putative Contributors to the Obesity Epidemic”. Critical Reviews in Food Science and Nutrition 49.10 (2009): 868-913.
  13. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders”. 5th edition. Arlington, Va, USA: American Psychiatric Press (2013). 
  14. Styne DM., et al. “Pediatric Obesity-Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline”. The Journal of Clinical Endocrinology and Metabolism 102.3-1 (2017): 709-757.
  15. Williamson DF., et al. “Smoking Cessation and Severity of Weight Gain in a National Cohort”. The New England Journal of Medicine 324 (1991): 739-745.
  16. Wadden T.A., et al. “A two-year randomized trial of obesity treatment in primary care practice”. The New England Journal of Medicine 36.21 (2011): 1969-1979. 
  17. Esteve E., et al. “Gut microbiota interactions with obesity, insulin resistance and type 2 diabetes: did gut microbiota co-evolve with insulin resistance?” Current Opinion in Clinical Nutrition and Metabolic Care: 14.5 (2011): 483-490. 
  18. Crowley VE., et al. “Obesity therapy: altering the energy intake-and-expenditure balance sheet”. Nature Reviews Drug Discovery 1.4 (2002): 276-286.
  19. Rosamond W., et al. “Heart Diseases and Stroke Statistics - 2008 Update”. Circulation 117 (2008): e25-e146. 
  20. World Health Organization (WHO). (2008-2013) Action plan for global strategic for prevention and control of noncommunicable diseases (2015). 
  21. Jensen MD., et al. “AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society”. Circulation 129.2 (2013): S102-S138.
  22. Barlow S and Expert Committee. “Expert committee recommendations regarding prevention, assessment, and treatment of child and adolescent overweight and obesity: Summary report”. Pediatrics 120.4 (2007): S164-S192.
  23. Rueda-Clausen CF., et al. “New pharmacological approaches for obesity management”. Nature Reviews Endocrinology 9 (2013): 467-478.
  24. Calderon-Larranaga, A., et al. “Multimorbidity and weight loss in obese primary care patients: Longitudinal study based on electronic health records”. British Medical Journal Open 5.3 (2015): 1-9. 
  25. Mechanick JI., et al. “American Association of Clinical Endocrinologists' position statement on obesity and obesity medicine”. Endocrine Practice 18 (2012): 642-648. 
  26. Pasarica M and Topping D. “An evidence-based approach to teaching obesity management to medical students”. MedEd PORTAL 13 (2017): 10662. 
  27. Centers for Disease Control and Prevention (CDC) (2014). 
  28. Centers for Disease Control and Prevention (CDC). Adult obesity: Obesity rises among adults. [National Center for Chronic Disease Prevention and Health Promotion: Division of Nutrition, Physical Activity and Obesity]. CDC Vital signs (2010). 
  29. McAllister EJ., et al. “Ten Putative Contributors to the Obesity Epidemic”. Critical Reviews in Food Science and Nutrition 49.10 (2009): 868-913.
  30. Leroux JS., et al. “Beyond the “I” in the Obesity Epidemic: A Review of Social Relational and Network Interventions on Obesity”. International Journal of Obesity (2013): 1-10.
  31. Flegal KM., et al. “Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis”. Journal of the American Medical Association 309.1 (2013): 71-82. 
  32. US Department of Health and Human Services. “The Surgeon General's call to action to prevent and decrease overweight and obesity”. Report (2001). 
  33. Thompson D., et al. “Lifetime health and economic consequences of obesity”. Archives of Internal Medicine 159.18 (1999): 2177-2183.
  34. Wang YC., et al. “Health and economic burden of the projected obesity trends in the USA and the UK”. Lancet 378 (2011): 815-825.
  35. Pollack A. “AMA Recognizes Obesity as a Disease. NYTimescom (2013). 
  36. WHO Obesity and overweight. WHO (2014). 
  37. Barquera S., et al. “Cardiovascular diseases in mega-countries: the challenges of the nutrition, physical activity and epidemiologic transitions, and the double burden of disease”. Current opinion in lipidology 27.4 (2016): 329-344. 
  38. David BA., et al. “Antipsychotic‐induced weight gain: A comprehensive research synthesis”. The American Journal of Psychiatry 156 (1999): 1686-1696. 
  39. Masand PS. “Weight gain associated with psychotropic drugs”. Expert Opinion on Pharmacotherapy 1 (2000): 377-373. 
  40. Pijl H and Meinders AE. “Body weight changes as an adverse effect of drug treatment. Mechanisms and management”. Drug Safety 14 (1996): 329-342. 
  41. Nasrallah H. “A review of the effect of atypical antipsychotics in weight”. Psychoneuroendocrinology 28 (2003): 83-99.
  42. Avena NM., et al. “Further developments in the neurobiology of food and addiction: Update on the state of the science”. Nutrition 28 (2012): 341-343. 
  43. Davis C and Carter JC. “Compulsive overeating as an addiction disorder. A review of theory and evidence”. Appetite 53 (2009): 1-8. 
  44. Lobstein T., et al. “Child and adolescent obesity: part of a bigger picture”. Lancet 385 (2015): 2510-2520.
  45. Lobstein T., et al. “Obesity in children and young people: a crisis in public health”. Obesity Reviews 5 (2004): 4-85.
  46. Abdullah A., et al. “The number of years lived with obesity and the risk of all-cause and cause-specific mortality”. International Journal of Epidemiology 40 (2011): 985-996.
  47. Schwartz MW., et al. “Obesity pathogenesis: an endocrine society scientific statement”. Endocrine Reviews 38.4 (2017): 267-296.
  48. Poirier P. “Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 american heart association scientific statement on obesity and heart disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism”. Circulation 113.6 (2006): 898-918.
  49. Litwin SE. “Which measures of obesity best predict cardiovascular risk? ” Journal of the American College of Cardiology 52.8 (2008): 616-619.
  50. Cook S., et al. “Clustering of cardiovascular risk factors mimicking the human metabolic syndrome X in eNOS null mice”. Swiss Medical Weekly 133 (2003): 360-363.
  51. Bosy-Westphal A., et al. “Common familial influences on clustering of metabolic syndrome traits with central obesity and insulin resistance: the Kiel obesity prevention study”. International Journal of Obesity 31 (2007): 784-790. 
  52. Hong Y., et al. “Metabolic syndrome, its preeminent clusters, incident coronary heart disease and all-cause mortality-results of prospective analysis for the Atherosclerosis Risk in Communities study”. Journal of Internal Medicine 262 (2007): 113-122. 
  53. WHO. Global Strategy on Diet, Physical Activity and Health (2020).
  54. Hill JO and Melanson EL. “Overview of the determinants of overweight and obesity: current evidence and research issues”. Medicine and Science in Sports and Exercise 31 (1999): 515-521.
  55. Nisbett RE. “Determinants of food intake in human obesity”. Science 159 (1968): 1254-1255.
  56. Peters JC., et al. “From instinct to intellect: the challenge of maintaining healthy weight in the modern world”. Obesity Reviews 3 (2002): 69-74.
  57. Perri MG and Corsica JA. “Improving the maintenance of weight lost in behavioral treatment of obesity”. In: Wadden TA, Stunkard AJ, eds. Handbook of Obesity Treatment. New York: Guilford (2002): 357-379.
  58. Stunkard AJ., et al. “Energy intake, not energy output, is a determinant of body size in infants”. The American Journal of Clinical Nutrition 69 (1999): 524-530.
  59. Brownell KD. “The central role of lifestyle change in longterm weight management”. Clinical Cornerstone 2 (1999): 43-51.
  60. Wadden TA., et al. “Benefits of lifestyle modification in the pharmacologic treatment of obesity: a randomized trial”. Archives of Internal Medicine 161 (2001): 218-227.
  61. Olshansky SJ., et al. “A potential decline in life expectancy in the United States in the 21st century”. The New England Journal of Medicine 352.11 (2005): 1138-1145. 
  62. Committee on Accelerating Progress in Obesity Prevention. “Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation”. National Academies Press (2012). 
  63. Barlow SE., et al. “Medical evaluation of overweight children and adolescents: reports from pediatricians, pediatric nurse practitioners, and registered dietitians”. Pediatrics 110.1 (2002): 222-228.
  64. Galuska D., et al. “Are health care professionals advising obese patients to lose weight? ” Journal of the American Medical Association 282 (1999): 1576-1578. 
  65. Yeh HC., et al. “Independent but coordinated trials: insights from the Practice-based Opportunities for Weight Reduction Trials Collaborative Research Group”. Clinical Trial 7 (2010): 322-332. 
  66. Wadden TA., et al. “A two-year randomized trial of obesity treatment in primary care practice”. The New England Journal of Medicine 365 (2011): 1969-1979. 
  67. Appel LJ., et al. “Comparative effectiveness of weight-loss interventions in clinical practice”. The New England Journal of Medicine 365 (2011): 1959-1968. 
  68. Bennett GG., et al. “Obesity treatment for socioeconomically disadvantaged patients in primary care practice”. Archives of Internal Medicine 172 (2012): 565-574. 
  69. Moyer VA. “Services Task Force Screening for and management of obesity in adults. U.S. Preventive Services Task Force recommendation statement”. Annals of Internal Medicine 157 (2012): 373-378. 
  70. Centers for Medicare and Medicaid Services. Decision memo for intensive behavioral therapy for obesity (CAG-00423N) (2012). 
  71. Malik VS., et al. “Global obesity: trends, risk factors and policy implications”. Nature Reviews Endocrinology 9.1 (2013): 13-27. 
  72. Sainsbury A and Hay P. “Call for an urgent rethink of the ‘health at every size’ concept”. International Journal of Eating Disorders 2 (2014): 8. 
  73. Hurt R., et al. “The Obesity Epidemic: Challenges, Health Initiatives, and Implications for Gastroenterologists”. Gastroenterology and Hepatology 6.12 (2010): 780-792.
  74. Nichols M., et al. “European Cardiovascular Disease Statistics. European Cardiovascular Disease Statistics 2012 edition”. Brussels, Belgium: European Heart Network AISBL (2012).
Citation: Nicholas A Kerna., et al. “Fundamental Factors of Overweight, Obesity, and Metabolic Syndrome in Cardiovascular Disease (Key Points that Healthcare Providers, Public Health Policymakers, and the General Public Should Know about the CVD-Obesity Connection)”. EC Cardiology 7.4 (2020): 45-54.

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