High physical activity (PA) levels or exercise training (ET) should be an integral part of any treatment plan for obese individuals regardless of weight loss goals, and is associated with numerous CV benefits 9. Although, the findings of the obesity paradox have been verified in several studies within different clinical populations 6- 8, at the present time, little evidence exists that lower survival is observed in adults with CV diseases after modest or clinically significant weight loss. Recent epidemiological evidence has emerged showing greater survival in adults with CV diseases with higher obesity levels compared to lower levels, which has been coined “the obesity paradox” 5. Thus, a strong rationale exists for clinicians to advocate that overweight and obese patients attempt at least modest weight loss. Clinically significant weight loss (≥ 5% of baseline body weight) has been shown to be more effective in reducing CV and T2DM risk factors 4. Weight loss in these patients have been associated with improvements in many cardiometabolic risk factors such as prevalence of the metabolic syndrome, insulin resistance, type 2 diabetes (T2DM), dyslipidemia, hypertension, pulmonary disease, CV disease, and inflammation 3. The American Heart Association's scientific statement on obesity and weight loss 3 recommends weight loss in overweight and obese patients to reduce the severity of CV risk factors. Obesity is a major risk factor for many cardiovascular (CV) diseases such as coronary heart disease (CHD), heat failure (HF), stroke, ventricular dysfunction, and cardiac arrhythmias 3. The total medical cost associated with treating obesity exceeds $140 billion annually, and represents approximately 9.1% of annual medical expenditures 2. In the United States, 66.3% of adults are overweight or obese 1, which represents a major public health concern. Rationale for weight loss in overweight and obese patients
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