Is weight loss effective as a preventive measure against heart disease?

For the vast majority of overweight and obese people, reasonable weight loss is indeed a very cost-effective preventive measure for heart disease, but it is by no means applicable to everyone. Blind weight loss may cause irreversible damage to the heart.

Two years ago, when I accompanied my family to the cardiology department for a review, I met a 42-year-old Internet programmer who was 175cm tall and weighed almost 190 kilograms. His belly was as bulging as a watermelon. At that time, it was found that his coronary arteries had mild atherosclerotic plaques, and his blood lipids and blood pressure were all over the standard. The doctor did not prescribe him many medicines. The first requirement was to reduce his weight to less than 160 kilograms within half a year. He later followed the nutrition department's customized diet, took 40 minutes of brisk walking every day after get off work, and occasionally played badminton with friends on weekends. He did not diet or eat any random weight-loss products. He lost 34 pounds in 8 months. When he was re-examined, his blood lipids and blood pressure returned to the normal range, and the plaques did not progress. The director said that this was equivalent to cutting the risk of myocardial infarction by 60% in the next 10 years.

In fact, the truth is simple. When you are overweight, there are many tissues that need blood supply throughout the body, and the heart has to work like a 20-pound rice bag every day. Every beat is harder than ordinary people. Excess fat will continue to deposit on the blood vessel walls. Over time, the coronary arteries that supply blood to the heart will be blocked, and the risk of coronary heart disease and myocardial infarction will naturally increase. Losing excess fat is equivalent to unloading the burden on the heart, the pressure on blood vessels will also decrease, and the three high blood pressure will improve, which will naturally reduce the risk of heart disease.

However, I have also encountered many doctors who hold the opposite view, saying that losing weight to prevent heart disease should not be messed up. Previously, there was a 68-year-old aunt in the heart disease patient group. She had atrial fibrillation and sarcopenia. She weighed only 102 pounds, but her body fat rate was slightly higher. She followed other people's advice that losing weight was good for the heart, so she followed a diet. As a result, she fainted once in half a month and was sent to the emergency room. The doctor scolded her, saying that she did not have enough muscle mass. Blindly losing weight would only make the contractility of the myocardium worse and worse, which would increase the frequency of atrial fibrillation attacks. In severe cases, it may even induce heart failure. There was also a case reported to a local hospital last year. A 26-year-old girl lost 28 pounds by fasting for two months and taking diet pills to take wedding photos. In the end, hypokalemia induced myocarditis and she stayed in the hospital for more than half a month. Her originally good heart suddenly developed the sequelae of premature beats.

In fact, there is no absolute right or wrong in this matter. It all depends on the people it is suitable for and the way to lose weight. If your BMI is within the normal range (18.5-23.9) and you don’t have abdominal obesity or high blood pressure, there is absolutely no need to forcefully lose weight to prevent heart disease. Especially if young people pursue “white skinny” and lower their BMI below 18, it will lead to insufficient myocardial strength and increase the risk of arrhythmia. But if you are overweight or even obese, especially abdominal obesity with a thick waist and big belly, and also have problems with high blood pressure, hyperlipidemia, and high blood sugar, then steadily losing 10%-15% of your weight will be more beneficial to your heart than no matter how many health supplements you take.

Just don’t try to lose weight quickly. It is safest to lose no more than 1 kilogram per week. Don’t just rely on starvation. Do more strength training to build some muscle. Only when the muscle mass increases can the basal metabolism be stabilized and the burden on the heart can be really reduced. If you rely on extreme methods to lose weight, the weight will increase faster when you come back, and the heart will suffer twice. It is really not a crime.