Overweight and obesity: an emerging problem in patients with congenital heart disease

Abstract

Due to technological and medical advances the population of adults with congenital heart disease (ACHD) is constantly growing. Worldwide, congenital heart disease (CHD) affects 1.35-1.5 million children each year and the number of ACHD meanwhile exceeds the number of CHD children. It has been found that a substantial number of ACHD present problematic health behaviors, such as physical inactivity and bad nutritional habits. Recent studies document alarming rates of overweight and obesity among CHD patients which may consequently lead to further health complications in this population. The present article focuses on the distinct psychosocial effects resulting from the diagnosis of CHD and their impact on developing disordered eating patterns and excess weight. It seeks to identify unique risk factors and relevant explanations associated with the increasing prevalence of obesity among CHD patients. This review suggests a vital need to establish clinical guidelines for nutrition and weight management in this patient population as part of a holistic treatment approach.

Keywords: Congenital heart disease (CHD); chronic disease; obesity; overweight; prevention.

Figure 1

Prevalence of overweight and obesity in CHD patients. *, Barbiero et al., Pinto et al., Shustak et al. assessed pediatric CHD patients according to CDC guidelines (overweight: BMI ≥85–95% percentile, obesity: BMI ≥95% percentile). Lerman et al. assessed ACHD according to BMI classifications according to the Quetelet Index (overweight: 25 kg/m² ≤ BMI <30 kg/m², obesity: BMI ≥30 kg/m²). CHD, congenital heart disease.

Figure 2

Factors associated with obesity in congenital heart disease (CHD) patients.