Tailored weight-management recommendations for obesity patients with cardiovascular-metabolic diseases

Obesity represents a global health issue that profoundly impacts health and associated consequences.1 The global population inflicted with obesity alone or alongside cardiovascular-metabolic diseases (CVMD) presents an expanding global health challenge. The recent clinical consensus statement emphasizes the epidemiology and etiology of obesity and CVMD, as well as its clinical management.1 There is hope, as the tools available to manage this epidemic continue to expand, encompassing a variety of options that include lifestyle modifications, pharmacological therapies, and surgical interventions. Furthermore, the advent of cutting-edge technologies (AI, LLMs, wearable devices, etc.) is seen to pave the way for innovative approaches to early intervention.

Obesity is recognized as a chronic relapsing disease that compromises the quality of life and shortens lifespan, with most of the mortality attributable to CVMD. The intricate relationship between obesity and CVMD needs a comprehensive approach to weight management. Obesity remains an under-recognized and poorly addressed problem.1 This multifaceted challenge requires not only an understanding of the mechanisms underlying the relationship between obesity and CVMD, but also the implementation of interventions tailored to the unique needs. This guideline discusses tailored weight-management recommendations for obesity patients with CVMD, emphasizing lifestyle modifications, pharmacological therapies, surgical interventions, and ongoing research and references for clinical treatment.

Methods

This guideline was developed by a multidisciplinary panel (endocrinologists, cardiologists, bariatric surgeons, etc.). We systematically reviewed evidence from 2014 to 2024, prioritizing randomized controlled trials (RCTs) and systematic review and meta-analyses. Cohort studies and real-world evidence were also considered, case reports and case series were excluded. We used body mass index (BMI) as the criterion for differentiating interventions. The formula is: BMI = weight (kg)/(height [m]).2 The recommendations are summarized.