In my practice, I focus on obesity and cardiovascular health only when weight clinically affects heart health. Obesity, in isolation, if all else is optimized, offers only slight improvement if corrected.
Obesity has become a sociopolitical topic rather than a medical one. In my practice, I don’t focus too much on obesity unless it is a unique contributor to my client’s heart health.
Obesity in Healthcare
In western medicine, the patient is considered sick if their BMI is over 25. The patient will always have an ICD-10 code stuck somewhere in their medical chart.
It’s hard to know why conventional medicine manages patient health in such a way. Perhaps it expedites care and makes insurance billing simpler.
It is true that carrying extra weight puts most people at increased risk of insulin resistance, joint problems, sleep apnea, certain cancers, and other metabolic issues. But not everyone.
A person can be obese (BMI > 25) and relatively healthy. They manage their stress well, they are active, and their diet is optimized for their individual needs.
Vice versa, a person can have a normal BMI and not have an ideal metabolic profile. They can still have sleep apnea, hypertension, insulin resistance, and increased cancer risk.
Personal Perspective on Weight and Heart Health
I have clients who carry extra weight but live a good life. They have a diet that fits their individual needs, and they aren’t suffering in any significant way due to their weight.
For such individuals discussing obesity is clinically unnecessary. The minor percentage points of health advantages may not be worth the effort needed to change their weight.
If weight is an important topic, however, affecting their heart health, then we make that a priority. Think of sleep apnea or insulin resistance.
Obesity And Heart Health
I’ve worked with many heart health coaching clients and many of heart risk factors due to their lifestyles. Much more so than due to their body mass index.
We work together to improve their diet, stress, exercise, breathing, chemical exposures, and relationships that change their heart disease risk and improve their heart health.
If my client has the ideal diet, lifestyle, clean environment, sleep, and social support but remains overweight or obese, then we perform calculations to assess their ongoing risk.
This final risk score is how we determine if a weight reduction would add meaningful results; if it would improve this person’s heart health.
The Current Obesity Research
Look, all else equal, it’s potentially better to have a lower BMI – up to a point, of course.
However, we’re talking about an individual and not the population. The current research, just like most research, uses statistics to draw general conclusions. And it generally states a strong correlation between obesity and cardiovascular health.
General conclusions don’t define you and must be carefully applied to individuals. Otherwise, it’s easy to do a lot and not get results.
Most individuals who suffer from obesity also tend to have poor diets. They tend to be sedentary and, therefore, strongly correlate their weight and heart health.