Obesity and cardiovascular disease consensus statement
Introduction
Overweight and obesity is a critical and growing public health concern in Australia and globally. Two thirds of adults in Australia are affected by these conditions.1, 2 Overweight/obesity is currently the leading risk factor for disease burden, contributing 8.3%, surpassing tobacco use at 7.6%.3 The proportion of adults living with obesity specifically has increased from 19% in 1995 to 32% in 2022.1 By 2035, it is projected that 47% of all adults in Australia will be living with the condition.4
These trends have profound implications for cardiovascular disease (CVD), a leading cause of morbidity and mortality in Australia.5 Excess adiposity contributes to hypertension, dyslipidaemia, insulin resistance and systemic inflammation, all of which accelerate the development of coronary heart disease, stroke, heart failure and atrial fibrillation.6
Obesity is a multifaceted condition underpinned by a broad and complex range of drivers that extend beyond the scope of clinical intervention.7 System-level and environmental factors play a profound role, and while not addressed in detail in this consensus statement, are critical to tackling the growing problem of obesity in Australia.
Despite the strong causal link between obesity and several cardiovascular conditions, gaps persist in prevention and management across the Australian healthcare system. Obesity remains overlooked as a modifiable risk factor for CVD, while stigma and inequities in access to effective treatment further compound the burden.8 Current clinical guidelines offer limited integration of obesity management within cardiovascular care pathways. This underscores the need for a coordinated, multidisciplinary approach that primary healthcare professionals, specialists and allied healthcare professionals can collectively use to support people living with obesity.9
New incretin-based therapies, such as GLP-1 receptor agonists and dual GIP/GLP-1 receptor agonists, have revolutionised obesity treatment. These agents offer highly effective options for weight management, with demonstrated positive cardiovascular outcomes, including for people with established CVD or risk factors. There are also many other incretin-based therapies currently in development and undergoing further testing in clinical trials.
To help address current gaps and the growing need for practical guidance in this evolving area of medicine, this consensus statement has been developed to guide healthcare professionals, policy makers, researchers and peak bodies in delivering equitable, person-centred strategies to reduce cardiovascular risk and improve long-term health outcomes for adults in Australia living with overweight and obesity.
The consensus statement is intended to complement the National Health and Medical Research Council (NHMRC)’s Clinical Practice Guidelines for the Management of Overweight and Obesity for Adults, Adolescents and Children in Australia. It provides healthcare professionals with practical advice for managing overweight or obesity in the context of CVD, including detailed pharmacotherapy guidance for this specific patient cohort.