Weight control isn’t simply about being thin. It’s about lifestyle management to reduce the risks of heart disease. Losing weight alone won’t lessen that risk. Heart-healthy weight is about eating good foods, exercising regularly, balancing the number of calories you consume with the number of calories your body uses. It is important to avoid the extremes of obesity and anorexia that can seriously damage your heart — and threaten your life.
Maintaining a healthy body mass index (BMI) is the key for a healthy heart, stressed Joanne Foody, MD, medical director of the Cardiovascular Wellness Center at Brigham and Women’s Hospital in Boston. Maintaining a healthy BMI — between 18.5 and 24.9 — can help reduce risk for heart disease and improve overall health. In addition, Dr. Foody noted, the American Heart Association recommends the following seven factors to reduce your heart disease risk.
  1. Be active
  2. Control your cholesterol
  3. Eat a healthy diet
  4. Manage your blood pressure
  5. Lose weight
  6. Reduce your blood sugar
  7. Stop smoking
“By incorporating those seven factors into your daily life,” said Foody, “you can reduce your risk of heart disease by 80 percent, but less than 1 percent of Americans do those things.”

Obesity’s Heart Disease Risks

Almost 70 percent of the United States population is overweight or obese, according to the U.S. Centers for Disease Control and Prevention. This increases risks for hypertension, diabetes, and atherosclerosis, or a build-up of plaque inside the arteries that carry oxygen-rich blood to the heart. These problems are serious risk factors for heart disease.
Coronary heart disease (CHD) is the leading cause of death for men and women nationwide. As the plaque or waxy substance builds up inside the coronary arteries, the flow of blood narrows. Blockage of one of these vessels causes a heart attack. When the heart can no longer pump the amount of blood needed for your body to function properly, heart failure will result.
Francisco Lopez-Jimenez, MD, director of preventive cardiology at the Mayo Clinic, said that in addition to increasing blood pressure and diabetes, obesity is a risk factor for sleep apnea and atrial fibrillation, an irregular heartbeat. “It’s essential,” he said, “that for patients to maintain a healthy weight, they must be careful about what they eat and engage in physical activity regularly.”
“In our society,” added Foody, “where people aren’t very active, weight gain tends to be incremental.” She said the average person gains about 5 pounds during the holiday season each year — and never loses them again. Weight gained year after year after year, she stressed, leads to poor health, obesity, and heart disease. “The solution,” she urged, “is to be vigilant about maintaining your weight at a specific healthy level.”

Anorexia’s Effect on the Heart

Anorexia, self-starvation, is a serious psychological problem that along with bulimia accounts for the highest mortality rate of any psychiatric disorder. An anorexic person denies his or her body the nutrients it needs to function normally, reducing heart size and causing dangerously low blood pressure.
“In anorexic patients,” said Foody, “the heart becomes atrophied, blood pressure plummets, and serious complications such as heart failure and cardiac arrest can result.”
Jennifer Haythe, MD, assistant professor of clinical medicine in the division of cardiology at New York-Presbyterian/Columbia University Medical Center in New York, said that malnourishment can cause critical electrolyte disturbances in the body that can lead to heart failure, arrhythmias, and even sudden death. She added, though, that if weight is gained in time, heart problems usually improve.
The goals for optimal heart health, said Foody, are to maintain a healthy, steady weight; eat healthy foods; and engage in regular physical activity. Doing those things will lessen your risk of blood pressure and cholesterol problems and the onset of diabetes. But if you’re already obese or anorexic, she recommended addressing the underlying causes before lifestyle changes can be successful.