Obesity and cardiovascular risk

In most industrialized countries, 40-60% of the population is now overweight or obese. Obesity has recently been recognized as a major modifiable risk factor for cardiovascular disease, second only to cigarette smoking. Excess weight and obesity markedly increase the risk for hypertension, diabetes, coronary artery disease and congestive heart failure in both men and women. Populations most severely affected include the poor, the uneducated and certain racial and ethnic groups. Obesity is currently classified based on body mass index (BMI), but measurement of waist circumference as an important determinant of cardiovascular and metabolic risk is receiving increasing acceptance. For moderate overweight and obesity, interventions include dietary modification, increasing physical activity, behavior therapy and pharmacotherapy. Surgery is currently the only viable approach to morbid obesity. (C) 2003 Elsevier Science Ltd. All rights reserved.