Obesity-related cardiometabolic complications.

Obese patients are at increased risk for developing numerous cardiometabolic complications, including hypertension, insulin resistance, diabetes mellitus, dyslipidemia, and cardiovascular disease (CVD). These complications are associated with an increase in mortality and appear to be related to the changes in adipocytcs that occur with obesity. The enlarged adipocytes found in obese individuals release more glycerol, free fatty acids, and proinflammatory factors and less adiponectin. Some of these changes result in insulin resistance, which appears to be integral to the development of the obesity-associated cardiometabolic complications. Weight loss and increased physical activity are key to reducing the risk for obese individuals to develop cardiovascular complications. However, many patients also require drug therapy. Because many obese patients have multiple cardiometabolic complications, ideally, drug therapy that has positive effects on multiple CVD risk factors should be used. Therapies directed at obesity, such as sibutramine and endocannabinoid receptor blockers (eg, rimonabant), have shown improvements in weight, blood pressure, the lipid profile, and glucose levels.