Obesity is major contributor to heart disease, impediment to diagnosis and treatment

September 18, 2012
Obesity is a major contributor to heart disease that substantially hinders the disease’s proper diagnosis and treatment, says a cardiologist researching the impact of obesity and weight loss on the heart. With obese youth as the fastest-growing demographic group, the country’s problem is only going to get worse, says Dr. Sheldon Litwin, a preventive cardiologist and Chief of the Medical College of Georgia Section of Cardiology at Georgia Health Sciences University. Credit: Phil Jones, GHSU campus photographer

Obesity is a major contributor to heart disease that substantially hinders the disease's proper diagnosis and treatment, says a cardiologist researching the impact of obesity and weight loss on the heart.

With obese youth as the fastest-growing , the country's problem is only going to get worse, said Dr. Sheldon Litwin, a preventive and Chief of the Medical College of Georgia Section of Cardiology at Georgia Health Sciences University.

About half of Litwin's patients at GHS Health System have obesity-related , with , hypertension and diabetes as contributing factors. "Now I am seeing 25-year-olds weighing 350 pounds who present with chest pain or shortness of breath," he said.

"The problem is of enormous magnitude. Everything from the heart disease process to its diagnosis and treatment are affected by obesity. We see it every day. This really is the number-one issue facing us," Litwin said of his cardiology colleagues.

One solution may be gastric bypass surgery which spurs weight loss much faster than as it lessens , said Litwin, a co-author of a study published in a September obesity theme issue of the .

The Utah Obesity Study followed more than a 1,000 severely for six years. About a third had gastric bypass surgery and the remainder either didn't seek or couldn't get the surgery. experienced about a 30 percent weight loss compared with none in controls and had significant reductions as well in . They experienced a healthy downsizing of their heart's pumping chamber and a profound reduction in the incidence of both active and new diabetes as well as , elevated and sleep apnea. Fitness and overall quality of life improved.

"I would much rather see everybody out there riding their bikes, walking, running, going to the gym. No question that is better than having surgery," said Litwin. However, surgery may be the only thing that enables many obese individuals to make these healthy lifestyle changes, he said. Litwin came to MCG in 2011 from the University of Utah School of Medicine and now works as part of the multidisciplinary team treating morbidly obese patients at GHS Health System.

Excessive fat literally gets in the way of sound waves or X-rays used to diagnose heart disease so resulting images are often inconclusive. Tables where patients lie to get a cardiac catheterization, which can aid diagnosis as well as treatment, typically can't accommodate patients weighing over 400 pounds. While equipment is being adapted for larger patients, the resulting image likely won't improve and the adaptations won't be widely available for several more years, Litwin said.

In the meantime, patients who aren't candidates for or other invasive treatments, are typically prescribed a drug regimen based on symptoms. However the drugs don't work that well either, possibly because dosing has not yet been adjusted for size, he said. "We see patients with hypertension who are on four drugs but aren't responding. One of the most common causes of resistant hypertension is obesity."

"This long-term study provides an objective assessment of what we see every day: bariatric surgery helps many patients make a healthy transformation, inside and out," said Dr. Michael A. Edwards, Director of the GHS Health System Weight Loss Center and Chief of the MCG Section of Minimally Invasive and Digestive Disease Surgery. "Critical to successful outcomes is proper screening to identify the best surgical candidates and the availability of a comprehensive weight loss team to complete a thorough health assessment, provide bariatric surgery options and provide support and information to make long-term healthy lifestyle changes." Edwards notes that a supervised medical weight loss program can help patients at high risk improve to the point of becoming safer candidates for weight-loss surgery.

The past two decades have yielded dramatic increases in obesity in the United States, according to the Centers for Disease Control and Prevention. Today more than one-third of adults and 17 percent of children and adolescents are obese; notably childhood rates have tripled since 1980.

An advocate of the emerging use of computerized tomography to quickly and non-invasively diagnosis heart disease in patients who, for example, come to an emergency room with chest pain, Litwin notes that the beating heart with its tiny arteries is an imagining challenge even without the obesity issue. He is corresponding author of a recent review article on the expanding role of CT in assessing and treating heart disease in the journal Trends in Cardiovascular Medicine.

Explore further: Bariatric surgery in adolescents improves obesity-related diseases within first 2 years

Related Stories

Bariatric surgery in adolescents improves obesity-related diseases within first 2 years

January 31, 2012
Today, about one in five children in the United States are obese. That means that in just one generation alone the number of obese kids in this country has quadrupled.

Exercise plays key role in managing obesity: study

February 21, 2012
(Medical Xpress) -- In spite of recent media reports suggesting that exercise may not be useful in obesity management, overweight and obese people should not be discouraged from taking it up, according to a paper published ...

Study: Obesity surgery can help prevent diabetes

August 22, 2012
Doctors are reporting a new benefit from weight-loss surgery — preventing diabetes. Far fewer obese people developed that disease if they had stomach-shrinking operations rather than usual care to try to slim down, ...

Recommended for you

Warning labels can help reduce soda consumption and obesity, new study suggests

December 15, 2017
Labels that warn people about the risks of drinking soda and other sugar-sweetened beverages can lower obesity and overweight prevalence, suggests a new Johns Hopkins Bloomberg School of Public Health study.

Parents modeling healthy behaviors leads to markedly better outcomes for children

December 13, 2017
When trying to help children lose weight, involving a parent in the treatment makes the entire family healthier, researchers at Washington University School of Medicine in St. Louis have shown.

'Obesity paradox' not found when measuring new cases of cardiovascular disease

December 7, 2017
Although obesity is a well-known risk factor for getting cardiovascular disease, a controversial body of research suggests that obesity may actually be associated with improved survival among people who have cardiovascular ...

Harmful effects of being overweight underestimated

December 1, 2017
The harmful effects of being overweight have been underestimated, according to a new study that analysed body mass index (BMI), health and mortality data in around 60,000 parents and their children, to establish how obesity ...

More than half of US children will have obesity as adults if current trends continue

November 29, 2017
If current trends in child obesity continue, more than 57% of today's children in the U.S. will have obesity at age 35, according to a new study from Harvard T.H. Chan School of Public Health.

Exercise alone does not lead to weight loss in women—in the medium term

November 23, 2017
Knowing whether or not exercise causes people to lose weight is tricky. When people take up exercise, they often restrict their diet – consciously or unconsciously – and this can mask the effects of the exercise. In our ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.