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J Am Coll Cardiol. 2018 Sep 25;72(13):1506-1531. doi: 10.1016/j.jacc.2018.08.1037.

Healthy Weight and Obesity Prevention: JACC Health Promotion Series.

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John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, Louisiana. Electronic address:
Department of Physical Therapy, College of Applied Health Science, University of Illinois at Chicago, Chicago, Illinois.
PROFITH "PROmoting FITness and Health through Physical Activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.
Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia, Missouri.
Northwestern University, Feinberg School of Medicine, Chicago, Illinois.


Overweight and obesity have reached epidemic levels in the United States and worldwide, and this has contributed to substantial cardiovascular and other health risks. However, controversy exists concerning the causes of obesity and effective modalities for its prevention and treatment. There is also controversy related to the concept of metabolically healthy obesity phenotype, the "obesity paradox," and on the importance of fitness to protect individuals who are overweight or obese from cardiovascular diseases. In this state-of-the-art review, the authors focus on "healthy weight" with the emphasis on the pathophysiologic effects of weight gain on the cardiovascular system; mechanistic/triggering factors; and the role of preventive actions through personal, education/environment, and societal/authoritative factors, as well as factors to provide guidance for caregivers of health promotion. Additionally, the authors briefly review metabolically healthy obesity, the obesity paradox, and issues beyond lifestyle consideration for weight loss with medications and bariatric surgery.


cardiovascular disease; healthy weight; obesity

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