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Obesity factors more complex than thought

Researchers and clinicians are taking a closer look at metabolic syndrome as an indicator of heightened risk for obese patients.

By Susan J. Landers, amednews staff. Jan. 17, 2005.

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Washington -- It's time for a little fine-tuning when it comes to assessing the cardiovascular risk posed by excess pounds, according to new findings that could enable physicians to better identify those overweight patients at imminent peril.

A determination of body mass index might not be the only number that counts anymore. Where the fat is stored, an individual's fitness level, blood markers for inflammation and the presence of metabolic syndrome also should be considered.

"Everyone who is obese does not seem to be at the same risk for cardiovascular disease," said Barbara Nicklas, PhD, associate professor in gerontology and geriatric medicine at Wake Forest University School of Medicine in Winston-Salem, N.C.

Dr. Nicklas was the principal investigator in a recent study that identified visceral fat as a prominent risk factor for postmenopausal women. The presence of fat surrounding internal organs also was the main determinant of who had metabolic syndrome, a condition that is believed to set the stage for future problems.

With recent figures showing that 65% of U.S. adults are overweight, physicians are sharpening their skills at counseling their patients to lose weight and become more physically active to reduce their risk of cardiovascular disease as well as diabetes and arthritis.

"The numbers out there are unbelievable," said Philip Ades, MD, professor of medicine at the University of Vermont College of Medicine. "When six of 10 patients are overweight and you are dealing with the medical issues, how could a doctor be in practice and not address this?"