How You Can Reduce The Risk Of Heart Disease Without Losing Weight.

Risk reduction is about addressing all factors, not just excess weight.

Being overweight is a major risk factor for heart disease and also an early death.

But even if you have excess weight, there are many things you can do to seriously reduce that risk without focusing on weight loss itself.

So, if you struggle with excess weight, you need to know what else you can do to reduce your future risk.

The Life Essential 8 are a set of factors that significantly influence your risk of heart disease and early death, including:

1. Regular Physical Activity.

2. Not smoking.

3. Good Diet.

4. Adequate Sleep.

5. Normal Cholesterol Levels.

6. Normal Blood Pressure.

7. No Diabetes or Pre-Diabetes.

The Life Essential 8 also include excess weight, but the question is whether those with excess weight who get the remaining seven factors right can significantly decrease their risk.

The answer is yes.

The magnitude of that risk reduction will surprise you.

A study of almost 10,000 adults with obesity (BMI >30) who were evaluated for all LE8 factors and followed for over 7 years can give us some insight¹.

The LE8 score was calculated for each person with a ranking of Low (0-49), Moderate (50-79) or High (80-100).

Over the 7-year period, the study assessed whether each person:

• Died from any cause.

• Died from heart disease.

• Died from something else not related to heart disease.

The study found that the higher/better a person’s LE8 score was, the less likely each of these three outcomes was to occur.

Compared to a low LE8 score, those with a moderate score were 37% less likely to die from any cause.

Those with a high LE8 score were 75% less likely to die from any cause.

This is a pretty amazing finding.

Many people who are overweight or obese and who cannot reduce their weight often feel that no matter what they do, they are not able to reduce their future risk.

This study says otherwise.

It strongly suggests that even with excess weight, adherence to excellent health principles can significantly reduce future risk.

Let’s see what happened to the other two groups.

For cardiovascular death, i.e. died from heart disease.

• Moderate Score - 39% reduced risk.

• High Score - 81% reduced risk.

For non-heart related deaths.

• Moderate Score - 36% reduced risk.

• High Score - 73% reduced risk.

Just to be clear.

Adherence to the other seven factors significantly reduced a person's future risk but did not eliminate it entirely.

But it made a huge difference if all the other seven factors were met.

Why is this case?

I suspect it comes down to two reasons.

Firstly, risk is a function of exposure to all of your risk factors combined.

If you have one unmanaged risk but address all the others, your overall risk will be reduced, and that is what we have seen here.

Secondly, not all excess weight or fat is created equal.

Excess weight or obesity is a function of excess fat, but if that fat is mostly subcutaneous rather than visceral, which sits in your liver and other organs, then the risk is likely to be less.

Those with excess weight who are eating well, sleeping well and exercising on a regular basis are also likely to reduce their harmful visceral fat.

And with this reduction in visceral fat comes a big reduction in risk.

Maybe not a big reduction in weight.

But it's the reduction in risk that interests us the most.

Can we take the obesity risk off the table also?

If you had asked me this five years ago, I would probably have said no.

But today?

The answer is probably yes for most people.

In an ideal scenario, excess weight could be eliminated using appropriate nutrition and exercise.

We know this works.

Over the short term.

The problem is that over longer time horizons, the impact for most people is modest at best.

With lifestyle approaches, most people will have only lost 2.45 kg at 3 years².

Not nothing, but often far short of the weight loss that is needed for many to move them into a normal weight category.

About 20% of people who lose weight over six months maintain that weight loss over the following five years.

But this also means that 80% of people will have regained most or all of the weight they had lost.

Newer weight loss therapies, broadly known as incretin modifiers, have radically changed what is now possible in terms of losing and maintaining weight loss.

Most people are familiar with these medications in the form of Ozempic, but a range of newer and more effective therapies are coming online and in development.

Newer therapies, such as retatrutide, can achieve a 25% weight loss in half of those who use the therapy, and about 90% will lose at least 10% of their body weight³.

For someone weighing 110 kg, that is a 27.5 Kg and 11 kg weight loss, respectively.

This weight loss is maintained, albeit with the continued use of the medication.

Just the same as you would expect with a blood pressure-lowering or cholesterol-lowering medication.

From this information, you should take away two key points:

1. Even if you have excess weight that you do not lose, your future risk can be significantly reduced but not eliminated.

2. If you wish to address the issue of excess weight, we have very effective therapies available and in development.

Excess weight and obesity have been the defining health issue of the last 20 to 30 years.

It seems there is a glimmer of hope that its reign may soon be ending or at least starting to fade.

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When You Are Ready, Here Is How We Can Help.

For an accessible and comprehensive overview of understanding and managing heart health, you can check out the best-selling book Heart. An Owner’s Guide.

For those based in Ireland, Dr Barrett works with a small number of clients to provide a comprehensive evaluation of cardiovascular risk and a tactical approach to maximally reducing that risk.

If you want to know more about a consultation with Dr Barrett, Click Here or on the button below.

In Case You Missed Them:

1. Life's Essential 8 and Mortality in US Adults With Obesity: A Cohort Study. Endocr Pract. 2024 Nov;30(11):1089-1096.

2. Intensity and duration of lifestyle interventions for long-term weight loss and association with mortality: a meta-analysis of randomised trials. BMJ Open. 2019 Aug 18;9(8):e029966.

3. Incretin-based therapies for the treatment of obesity-related diseases. npj Metab Health Dis 2, 31 (2024).