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Opinion

Let’s Talk About Obesity And Myths Related To Cardiovascular Disease — Dr Yap Jun Fai and Prof Dr Moy Foong Ming

In people with obesity, overproduction of the appetite-suppressing hormone leptin can result in paradoxical weight gain due to leptin resistance.

An obese woman. Picture by cocoparisienne from Pixabay.

Obesity is marked by an excess of adipose tissue, and women typically possess more adipose tissue than men.

In people with obesity, overproduction of the appetite-suppressing hormone leptin can result in paradoxical weight gain due to leptin resistance.

This hormonal imbalance also promotes vascular inflammation, consequently raising the risk of developing cardiovascular disease (CVD) in people with obesity.

The CVD risk is further heightened when women reach menopause, as the diminishing estrogen levels exert less protective antioxidant effect on the cardiovascular system.

Approximately 76.5 per cent of Malaysian patients who underwent percutaneous coronary intervention for a myocardial infarction were either overweight or obese.

Recognising this common link, we aim to debunk four common myths associated with obesity and CVD.

Myth 1: Only visible fat around the abdomen leads to a raised cardiovascular risk.
Fact: While abdominal fat is a recognised risk factor, visceral fat also contributes to CVD due to its highly active metabolic activity.

For instance, the deposition of fat around the liver, resulting in fatty liver is strongly associated with an increased risk of CVD.

Myth 2: Thin individuals or those having a normal body mass index (BMI) are not at risk for CVD.
Fact: Contrary to this belief, there exists a condition termed ‘normal-weight obesity syndrome’, characterised by excess adipose tissue (especially visceral fat) in individuals with a seemingly normal BMI (18.5 – 24.9 kg/m2).

In this context, even individuals of normal weight can acquire CVD if they exhibit other traditional risk factors such as habitual smoking, poor diet, physical inactivity or family history of premature coronary heart disease.

Myth 3: Losing weight quickly can reduce the risk of CVD.
Fact: Rapid, short-term weight loss can impose stress on the body. Development of complications like cholelithiasis, dehydration, malnutrition, or electrolyte imbalances can occur in extreme cases.

In contrast, adopting a gradual weight loss approach, combined with healthy lifestyle practices, has proven to be more beneficial. Additionally, individuals who lose weight slowly are more likely to maintain their weight loss over the long term.

Myth 4: Anti-obesity medications can completely offset the cardiovascular risks related to obesity.
Fact: While certain anti-obesity medications may assist in managing some risk factors of CVD (such as daily subcutaneous injection of glucagon-like peptide-1 receptor agonist – liraglutide in reducing blood glucose), they should only be utilised as a supplement to lifestyle interventions.

In other words, medications should be considered when weight loss goals cannot be achieved through lifestyle modifications alone. Most importantly, anti-obesity medications are not meant for everyone. Hence, anti-obesity medications should be used with medical supervision and careful long-term monitoring.

In alignment with World Obesity Day, celebrated annually on March 4, it is imperative to acknowledge obesity as a disease, especially as a precursor to the development of CVD.

It is recommended that all Malaysian adults undergo health screenings utilising BMI and waist circumference measurements to detect obesity early.

This proactive approach can also help to address co-occurring medical conditions that may contribute to CVD, such as diabetes mellitus, hypertension, or dyslipidemia.

Dr Yap Jun Fai and Prof Dr Moy Foong Ming are affiliated with the Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya and the Department of Public Health, University of Malaya Medical Centre.

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of Ova.

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