The Sobering Connection Between Obesity and Heart Disease

The Sobering Connection Between Obesity and Heart Disease

New studies and research show how your weight plays a huge role in the health of your heart.

By Lauren Gelman

On June 19, the world mourned the loss of James Gandolfini, one of television’s most beloved and talented actors, at the age of 51 of a suspected heart attack. (No official cause of death will be released until an autopsy is performed). Sanjay Gupta, MD, CNN’s chief medical correspondent, noted on CNN that usually first heart attacks don’t strike until after age 60, although risk factors such as obesity, smoking, lack of exercise, and stress can cause them to occur earlier.

But with the obesity epidemic growing in America, excess weight has overtaken smoking as the leading cause of premature heart attacks, cardiologist Peter A. McCullough, MD, told Reuters. In 2008, he led a study published in the Journal of the America College of Cardiology that found that obese people had a first heart attack 6.8 years earlier, on average, than people who had a more healthy weight. Severely obese individuals (with a BMI greater than 40) had a first heart attack 12 years earlier than those who were of normal weight.

An unrelated study published in 2011 in the American Heart Association’s journal Heart found that obese, middle-aged men were 60 percent more likely to die from a heart attack than a similar group of men who weren’t obese, even after researchers accounted for factors like cholesterol and blood pressure.

“This means [that] obesity itself may be causing fatal heart attacks through a factor that we have not yet identified,” Jennifer Logue, a clinical lecturer of metabolic medicine with the British Heart Foundation’s Cardiovascular Research Centre at the University of Glasgow, told USA Today.

Logue noted that fat cells may release inflammatory chemicals that damage the cardiovascular system, and that obese people may have larger hearts—to cope with their larger size—which may make the organ more stressed and vulnerable during heart attacks.

Obesity as a Serious Disease

Gandolfini’s devastating death comes after a recent announcement earlier this week from the nation’s largest group of doctors, the American Medical Association, who voted to classify obesity as a disease, rather than a risk factor contributing to other diseases like heart disease or obesity. The milestone decision was strongly supported by cardiologists and endocrinologists, who treat conditions directly influenced by obesity (heart disease and diabetes), and it is expected to influence how insurance companies cover treatment, such as weight-loss counseling, medication, and surgery.

By elevating obesity to more than a health concern or a risk factor in other diseases, the hope is that patients realize obesity can be due to complex changes in brain and body chemistry that make losing weight extremely difficult, and that physicians feel encouraged to play a more active role managing patients’ weight, says Louis Aronne, MD, director of the Comprehensive Weight Control Program at NY-Presbyterian/Weill Cornell Medical Center.

Losing Weight for a Healthier Heart

Weight-loss and chronic disease experts note that losing just 5 to 10 percent of excess body weight can have a huge impact in reducing the risk of illnesses like heart disease and diabetes. But science increasingly shows that losing weight isn’t just as simple as “eat less, exercise more.” Consuming too many calories, sugar, salt, and processed fats literally changes how your body’s hormones, digestive tract, and brain communicate with each other. This means obesity is often a multifaceted condition with complex causes, requiring  “a range of interventions”—including diet counseling, medication, and possibly surgery—to treat it.

Aronne says that an inability to lose weight isn’t a matter of lack of willpower or laziness. Obesity is a disease that requires treatment just like anything else. If you’ve struggled unsuccessfully to lose weight, talk to your doctor about your options.

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