Rising obesity is fuelling heart disease. We need a joint approach

Mariachiara Di Cesare is Director of the Institute of Public Health and Wellbeing at the University of Essex and Shreya Shrikhande is Science and Public Health Officer at the World Heart Federation.

Every day, more families around the world are losing loved ones to heart disease — a crisis quietly accelerated by rising obesity. Behind the statistics are real people: parents, partners, and children whose lives are cut short by a preventable epidemic.

A new report from the World Heart Federation highlights that cardiovascular deaths linked to obesity are climbing at an alarming rate — and if no action is taken, nearly two in three adults over 25 could be overweight or obese by 2050. 

But here’s the good news: this trajectory can be reversed, saving lives and easing the burden on our already strained healthcare systems. At the same time, reversing obesity and overweight levels will deliver trillions of savings.

Globally, over 1 billion children and adults are living with obesity, a figure four times higher than in 1990. 

The prevalence of obesity has increased in every country in the world with few exceptions such as women living in Spain, France, Moldova and Lithuania. 

While the highest levels are consistently recorded in Oceania, where 7 to 8 out of 10 adults were living with obesity, we have seen an important increase in many Pacific and Caribbean Island nations such as the Bahamas and Saint Kitts and Nevis, and in the Middle East and North Africa. In Qatar, Kuwait, and Egypt, 4 to 6 out of 10 adults live with obesity.

Obesity is a key risk factor for many conditions and is associated with 3.7 million deaths, half of which are due to cardiovascular diseases. 

But what do we know about the association between obesity and cardiovascular disease? 

Obesity impacts the way our body responds to insulin, the way the body's fat tissue works and the amount of fats in our blood: all of which, if not optimal, make heart problems worse. 

This includes conditions like coronary heart disease, heart failure, heart attacks, and blood clots. Obesity can also affect cardiovascular diseases indirectly, hindering their diagnosis, management, and treatment.

Unfortunately, the root causes of obesity are deeply social and systemic, but we can challenge this situation by encouraging governments to take bold, coordinated action. 

Tackling stigma

We know that social, psychological, biological, economic and environmental factors shape our risk of obesity and developing cardiovascular conditions. 

For example, having access to affordable healthy food, green spaces, active and healthy environments throughout our lives, and especially during childhood, decreases our risk of obesity and cardiovascular diseases. 

Yet multiple barriers halt individual and community capacity to access those resources. This is not because of individual choices, but the way resources are distributed and accessed across the global population.

We need bold political actions to build the future we want and deserve.

We need health plans that are fair and support the most affected. Important steps include making a national plan to fight obesity with clear goals, getting help from different areas like schools and workplaces, and making sure doctors and clinicians help people prevent and treat obesity. 

We ask for public health campaigns and policies that seriously tackle the stigmatisation of obesity; to fight the bias our society has built around the issue and to socially recognise obesity as a disease, not as an individual choice. 

Around the world, there are strong examples of successful action against obesity. 

Brazil uses clear front-of-pack nutrition labels. Mexico has taxed unhealthy foods and sugary drinks. Japan introduced nationwide food education for children. India’s “Eat Right India” campaign promotes healthy eating, and Gateshead in England has implemented restrictions on the opening of new fast-food outlets.

When people are diagnosed with obesity and cardiovascular conditions, we need clear guidelines. This includes ensuring that our health professionals have the knowledge, guidance and tools necessary to prevent, manage and treat obesity. 

We need to be sure that people diagnosed with obesity and cardiovascular disease have access to behavioural interventions and, when needed, to pharmacotherapy and surgery. This needs to be free or affordable for all to avoid discrimination. 

We must all remember that we have the power to curb this growing crisis and give millions a fighting chance at living longer, healthier lives.