What I Want You to Know About Weight and Heart Disease

Weight and Heart Disease: What’s the Connection?

Yes, excess weight can increase the risk of heart disease — but it’s not the full picture. Your weight is just one data point. What matters more is where weight is carried, what your metabolic markers show, and how your lifestyle supports or strains your heart.

It’s Not Just About BMI

BMI (body mass index) is an outdated tool. It doesn’t account for muscle mass, bone density, or fat distribution. Two people with the same BMI can have very different health profiles.

What matters more is body composition — specifically, visceral fat (fat around organs) vs. subcutaneous fat (under the skin). Visceral fat is more metabolically active and inflammatory — and more strongly linked to heart risk.

The Hidden Risks: Visceral Fat and Inflammation

Visceral fat contributes to chronic inflammation, insulin resistance, and hormonal imbalances. These can raise blood pressure, cholesterol, and triglycerides — key drivers of heart disease.

That’s why someone with a normal weight but a high waist circumference or insulin resistance may still be at risk.

Metabolic Health > Number on the Scale

Here’s what I look at in my clinic when assessing cardiovascular risk:

• Waist-to-hip ratio
• Fasting glucose and insulin levels
• Triglycerides and HDL cholesterol
• Blood pressure
• CRP (a marker of inflammation)

Improving these numbers matters more than hitting an arbitrary “goal weight.”

Weight Cycling (Yo-Yo Dieting) Can Be Harmful

Repeated cycles of losing and regaining weight can increase cardiovascular strain, elevate blood pressure, and negatively impact metabolic health.

That’s why I encourage slow, steady, sustainable changes — not crash diets or extreme restriction. Your heart benefits more from consistency than from dramatic swings.

Cardio Fitness Is a Stronger Predictor Than Weight Alone

Research shows that physically active individuals — regardless of size — often have better heart health than sedentary individuals at lower weights. Movement strengthens the heart, improves circulation, lowers inflammation, and helps manage stress.

Fit and active is a far better goal than “skinny at all costs.”

Heart Health Starts With Daily Habits

Here’s what I recommend to my patients (at any weight):

• 30 minutes of movement most days
• Prioritize fiber, healthy fats, and plant-based foods
• Manage stress with mindfulness, rest, or breathing
• Get labs checked annually
• Don’t smoke — and limit alcohol

Weight Loss Isn’t Always the Best First Goal

For some patients, improving sleep, stress, or blood sugar is more impactful than focusing on weight. When your body feels safer and less inflamed, weight loss (if needed) becomes easier and more sustainable.

Final Thoughts

Your heart doesn’t care about your jean size. It cares about inflammation, blood pressure, blood sugar, and how often you move.

Weight is part of the puzzle — but not the whole story. Let’s shift the focus from shrinking your body to strengthening your heart, stabilizing your metabolism, and building habits that support lifelong vitality.