Experts meeting at the 2nd International Congress on Abdominal Obesity (ICAO) issued a warning that millions of individuals around the globe are at risk from the cardiometabolic consequences of being overweight. Worryingly, the experts suggest that these people are not being identified by their doctors.
The International Chair on Cardiometabolic Risk (ICCR) released the statement from the ICAO, at a symposium sponsored by GlaxoSmithKline. The statement suggests that the media tends to focus on extremes when discussing obesity: either skinny celebrities who gain or lose a few pounds or the morbidly obese who need the help of fire-fighters to leave their homes. As the proportion of the general population which is overweight or obese increases, so the perception of what is the norm of a healthy weight is being reset. In the minds of society as a whole, including healthcare practitioners, the mental picture of an overweight or obese person has been reset inaccurately to a far heavier model.
Yet it is the millions across the world with BMIs above 25 who may already be suffering the early stages of high blood pressure, dyslipidemia and diabetes, who could benefit most from early intervention, say ICCR.
"Many primary care doctors may be treating obese patients with BMIs of 30 and above for the symptoms related to increased cardiometabolic risk, like pre-diabetes, dyslipidemia and hypertension, but not treating them for the underlying cause, their excess visceral adiposity," commented Professor Jean-Pierre Després, Scientific Director of ICCR and Professor, Faculty of Medicine, University Laval, Québec, Canada. Visceral adiposity is fat stored in the abdomen and around the vital organs. Excess visceral fat increases the risk of serious diseases, such as type 2 diabetes, stroke and heart disease.
"A patient with a BMI of 29 or 31 is the norm today yet when we think of an obese person, we tend to visualise someone with a much higher BMI of 40 plus. Patients with lower BMIs but higher levels of hidden, visceral fat are more difficult to identify yet can be at as much cardiometabolic risk as more obviously obese individuals", continued Professor Després. ICCR emphasised the need for urgent action to target these at-risk patients in order to slow the increasing rate of obesity across the world and stem the rising levels of diabetes and cardiovascular disease.
New research released at the Congress from the INternational Study of Prediction of Intra-abdominal adiposity and its RElationships with cardioMEtabolic risk/Intra-Abdominal Adiposity (INSPIRE ME IAA) supports the ICCR's position. INSPIRE ME IAA recruited 4,504 patients from 29 countries and showed harmful cardiometabolic risk profiles among non-diabetic, study participants, even among sub-groups of moderately overweight patients with an excess of visceral adipose tissue.
ICCR called for a renewed focus on what actually constitutes a healthy weight and how healthcare professionals support people in attaining and maintaining it. "In addition to patients who are clearly obese, we need to pay attention to overweight patients with visceral obesity who do not realise the potential dangers of the fat within their abdomen. Their doctor may not make this connection either. Yet a modest weight loss of just five or ten percent could result in a substantial loss of visceral adipose tissue and make all the difference to these people" stated Professor Després.
Modest gradual weight loss is recognised by most experts as the best way to lose and keep off weight, yet the diet industry and media fuel unrealistic expectations by promoting 'crash diets' and extreme dieters who slim to a fraction of their previous size. A lack of information and guidance on realistic approaches to and interventions which support modest weight loss is also considered by ICCR as a factor in the failure to reverse the tide of obesity.
As an organisation which strongly advocates a multidisciplinary approach to treating cardiometabolic risk factors, ICCR believes it is in a strong position to drive a renewed effort to overcome the multi-factorial barriers preventing healthcare professionals from turning the tide in the battle against obesity. ICCR also told the Congress it will seek to encourage and broaden the conversation around the concept of healthy weight in the hope of resetting the conversation around abdominal obesity, realistic weight loss and health.
email to a friend 
printer friendly 
opinions 
