Obesity is progressively becoming a major, world-wide threat to health. Due to its increasing prevalence in almost all countries, obesity is considered an epidemic, especially in developed countries such as Singapore. Overweight is also the most prevalent cardiovascular risk factor in patients with established coronary heart disease.

Obese individuals have both a worsened quality of life and shorter life expectancy than normal-weight individuals. Epidemiological studies have shown that obesity is a major risk factor for most severe cardiovascular outcomes, including coronary heart disease, heart failure, atrial fibrillation, ventricular arrhythmias, and sudden death. It is also considered a causal factor in hypertension, type 2 diabetes mellitus, osteoarthritis, obstructive sleep apnea, dyslipidemia, gastroesophageal reflux, non-alcoholic fatty liver disease, and many forms of cancer.

Multiple disease mechanisms are involved in cardiovascular diseases related to obesity: subclinical inflammation, endothelial dysfunction, increased sympathetic tone, atherogenic lipid profiles, enhanced thrombogenic factors, obstructive sleep apnea, etc.

Body mass index (BMI) is widely used as a surrogate measure of obesity. Many investigators acknowledge that BMI can underestimate the true prevalence of obesity, if defined as an excess of body fat content. Studies have shown an excellent correlation between body fat percentage (BF%) and glucose disorders even in subjects with normal BMI.