A Game-Changer for Heart Health

By Maria Fleet

Dr. Eldad Einav is the rare cardiologist who is also a medical weight management specialist. Though his dual specialty is unusual, it shouldn’t be. Heart health and weight are inextricably linked.

“The connection is very well established,” Dr. Einav states definitively. Not only does obesity contribute to risk factors like diabetes and high blood pressure that can lead to heart disease, he says, but obesity itself is an independent risk factor for heart disease

He sees obesity care as a key part of preventive cardiology, but that wasn’t always the case.

In his practice as a cardiologist, Dr. Einav had always discussed the health consequences of carrying excess weight with his patients, but he was frustrated with his lack of success in helping them lose weight successfully. He saw patient after patient work hard to follow nutrition plans and exercise guidelines, only to eventually regain any weight they lost. He thought, “Why is that?”

His search for an answer led him to become board-certified in obesity medicine. In the process he learned that obesity is a complex chronic disease, making it hard for most people to succeed long-term without targeted medical treatment.

“Our bodies were designed to store fat, not to lose weight,” he explains. “Fat tissue… serves as a very effective storage for a rainy day. But what happens now is we don’t have those rainy days anymore.” What we have instead is an abundance of highly available, calorie-dense foods. But our biological systems haven’t evolved as fast as the modern diet has. “Our bodies strongly resist when we try to lose weight,” Dr. Einav says.

One of his goals as a cardiologist has been to help his patients reach a healthier weight, and in turn improve their heart health.

Dr. Einav says the data from multiple studies show that weight loss, especially significant weight loss – that is, more than 10% of a person’s overall body weight – can prevent cardiovascular disease.*

Great news, but how to accomplish it? Dr. Einav’s answer is unambiguous.

“The only way that is supported with scientific evidence to sustain weight loss long term is with anti-obesity medications and/or bariatric surgery,” he says with straightforward clarity. He is uncompromising in his assertion that most people will find it impossible to accomplish sustainable weight loss without the assistance of a medical specialist.

Even if his patients don’t want to wade through the scientific reports that have come to this unwelcome conclusion, they usually have anecdotal evidence from their own lives that can corroborate it. They have a hard time losing weight, and if they do succeed, they can’t keep it off for long. “The number one thing that I want my patients to know is they are unlikely to achieve their goal on their own. And it’s not their fault,” Dr. Einav stresses.

“Fortunately, now we have new classes of medications for obesity and they show long-term success,” he says. The medications work by altering some of the hormonal signals that can interfere with the body’s ability to lose weight. Obesity medications represent a breakthrough for people struggling with extra weight, he believes, and also for doctors helping patients with excess weight improve their cardiovascular health. That’s critical because cardiovascular disease is the leading cause of death in North America.

In his practice, he combines medical treatment with a structured “lifestyle” program of proper nutrition, healthy food choices and regular exercise. The lifestyle component is essential, he says, but adds with characteristic directness, that “the lifestyle program is going to be easier when you’re on medications.” For example, Dr. Einav says that when patients use anti-obesity medications, they report being less hungry and feeling more satisfied with modest portions. He is optimistic about the future of medical weight management because the success rate seen with medications is equal to what could be achieved before only through bariatric surgery.

Dr. Einav encourages people who are struggling to keep weight off to ask their primary care physicians about medications, or to seek out an obesity specialist. Specialists like himself, Dr. Einav says, have the experience to be able to adjust the medications as needed, as well as to offer a concurrent lifestyle program that closely tracks a patient’s success.

Dr. Einav predicts that effective medical treatment for obesity will only continue to improve and become more available. There’s too much to be gained by helping people manage their weight successfully. The health benefits overall are huge, he stresses, and especially for the heart – by preventing heart attack, stroke and other cardiovascular outcomes, effective treatment can add years to a patient’s life.

As is his style, Dr. Einav puts it bluntly: “It’s a game-changer.”

The first step is talking to your family doctor about how they can help you reach a healthier weight and reduce your risk of cardiovascular disease. To find a physician near you who specializes in weight management, click here.