Obesity affects more than 40% of the U.S. population. The excess fat in obesity was originally thought to be harmless (benign). However, we now know that excess fat causes chemical changes in your blood that increase your heart disease risk. When your fat cells become enlarged, they give off hormones that produce chronic inflammation.

Inflammation can lead to your body no longer using insulin efficiently (insulin resistance). This means your body has trouble regulating your blood sugar levels, which can result in metabolic syndrome. Having this condition means you have risk factors that increase your chance of developing heart disease, such as:

Obesity also increases other heart disease risk factors, including:

How does body shape affect your heart disease risk?

Your risk of heart disease varies based on where your body stores excess fat. People with an apple shape (abdominal obesity) have a higher risk of heart disease than people with a pear shape. Your healthcare provider may measure your waist circumference to understand the degree of abdominal obesity you have as this correlates well with a higher risk of heart disease.

How else can obesity affect your heart?

Increased body fat may also directly contribute to changes in your heart, including:

Obesity also increases your risk of irregular heartbeat (atrial fibrillation). Research shows it may cause one-fifth of all cases of atrial fibrillation (Afib). Afib can lead to blood clots that cause stroke.

If I have obesity, how do I reduce my risk of heart disease?

Losing 5% to 10% of your weight can lower your risk factors for heart disease. Small lifestyle changes can help improve metabolic syndrome, which lessens your heart disease risk. These changes include:

  • Aerobic exercise: 150 minutes a week of aerobic exercise can help reduce abdominal fat and overall obesity. That works out to 30 minutes of activity, five days a week. Choosing activities that you enjoy, such as brisk walking, dancing or swimming, can help you stay motivated.
  • Dietary changes: Eating fewer calories can help reduce abdominal fat. Changing your diet can also help you lose weight and improve overall obesity. There are studies that support recommending the Mediterranean diet to help reduce your risk of heart attack and death related to heart problems. This diet includes eating mostly plant-based foods such as root and green vegetables, fresh fruits, legumes, nuts and whole grains, plus moderate servings of dairy, eggs, fish, lean poultry and seafood.

What other steps can I take to reduce my risk of heart disease?

Besides lifestyle changes, other options to help reduce your risk of heart disease include:

  • Behavioral therapies: Finding a counselor or support group can motivate you to meet your weight loss goals. Cognitive behavioral therapy can help you understand how your thoughts and emotions affect your behaviors.
  • Medications: Drugs for treating obesity can also help you lose weight. Ongoing studies are investigating whether these medications may also reduce your risk of heart failure.
  • Stopping smoking: Quitting smoking can lower your heart disease risk as well as risk of death from heart disease. Your healthcare provider can help you figure out a smoking cessation program that’s right for you.
  • Weight loss surgery: Bariatric surgery can reduce your risk of coronary artery disease as well as death from heart disease. Weight loss surgery can help you lose larger amounts of weight than lifestyle changes and also improves your metabolism.

See your healthcare provider to come up with a plan for your weight loss that makes the most sense for you.

A note from Cleveland Clinic

If you have obesity, you may be at a higher risk for heart disease. But there are a lot of things you can do to cut your risk and improve your overall health. Even losing 5% to 10% of your body weight can make a big difference. Small lifestyle changes, such as increasing exercise and improving your diet, can help reduce your heart disease risk. Medications and surgery are other options to help you lead a full, active life. Your healthcare provider can help you create an achievable plan to improve your health.

Last reviewed by a Cleveland Clinic medical professional on 08/08/2022.


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  • American Heart Association. More belly weight increases danger of heart disease even if BMI does not indicate obesity. (https://newsroom.heart.org/news/more-belly-weight-increases-danger-of-heart-disease-even-if-bmi-does-not-indicate-obesity) Accessed 8/16/2022.
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