Dr Gerhard Vosloo
Poor heart health sometimes filters into daily life long before a dramatic cardiac event happens. Excess weight can be part of the problem, particularly when fat accumulates around the waist and places additional strain on the cardiovascular system. For a nation faced with alarmingly high rates of heart conditions and obesity, it is critical that weight management care is urgently reassessed as a national priority.
Carrying extra weight means your body needs more blood to support the extra tissue, so the heart has to pump more with every beat. Over many years, that extra strain can cause the heart muscle to thicken, making it harder for the heart to relax properly between beats. Importantly, these changes can develop gradually, which is why weight, waist size, and blood pressure should be considered together rather than waiting for obvious heart symptoms to appear.
Losing weight reduces some of that workload, and doing so earlier may give the heart a better chance to recover before the changes become too difficult to reverse. Weight loss can also help improve blood pressure and reduce fluid build-up. This means that even before a person experiences a major heart problem, reducing excess weight may help address some of the factors placing the cardiovascular system under pressure.
This year’s World Heart Day on 29 September carries the theme ‘Don’t Miss a Beat’, drawing attention to signs of heart disease that can go unnoticed until they become emergencies. It is also a useful reminder that protecting heart health is not only about responding once symptoms appear. For people carrying excess weight, particularly around the waist, addressing weight and metabolic health can form an important part of reducing future cardiovascular risk.
What does weight loss with heart health in mind look like?
Before starting a weight-loss programme, it is important to understand whether excess weight is already affecting your cardiovascular and metabolic health. Your waist size, blood pressure, resting heart rate, medication, previous treatment, sleep, activity levels, and symptoms can help show whether excess weight is already placing extra strain on your heart and circulation. A holistic metabolic-management and weight-loss plan can then be designed with your specific needs in mind.
If prescription treatment is appropriate, doctors should use it carefully and adjust the dose according to each patient’s response, rather than increasing it automatically. Medication is only one part of effective weight management, alongside wider clinical factors that influence metabolic health and cardiovascular risk. For patients, this means medication should not be treated as a fixed-dose shortcut. Treatment needs to be monitored and adjusted as weight, appetite, blood pressure, and your overall health change.
Notably, rapid weight loss can carry serious consequences if lean muscle, nutrition, and physical strength are not protected along the way. Losing muscle may leave someone lighter on the scale without necessarily leaving them healthier or stronger. Enough protein, resistance training, appropriate supplementation, hydration, and regular follow-ups therefore all remain central to treatment. Doctors should then adjust your weight management programme as your weight, blood pressure, metabolic health, and treatment needs change.
With heart health specifically in mind, patients considering a metabolic weight management programme should complete blood tests before their consultation and give their doctor a full medical history. Physicians at Dr GL Vosloo Medical Practice assess key markers including blood count, kidney and liver function, cholesterol, and blood sugar, while also testing for insulin sensitivity, thyroid function, iron, vitamin D, and urine markers that can help identify early kidney problems linked to high blood pressure and diabetes. Together, these results give doctors a broader picture of the patient’s metabolic and heart health.
However, a blood panel is not a cardiac work-up and cannot replace one. It cannot diagnose an irregular heart rhythm, structural heart disease, or arterial disease. Patients experiencing symptoms such as unexplained breathlessness, chest discomfort, palpitations, or a noticeable decline in their ability to exercise should raise these with their doctor rather than assuming weight loss alone will address the problem.
Where a patient’s history, symptoms, examination, or results raise concern about any of these health issues, further cardiac assessment and, where appropriate, referral to a cardiologist may be needed. What the blood panel can establish is a clearer sense of the metabolic factors contributing to a patient’s cardiovascular risk, and whether further investigation may be warranted before treatment begins.
Following a doctor-prescribed programme, supported by regular follow-ups and adjustments as a patient’s needs and lifestyle change, can help patients lose considerable excess body fat while protecting muscle mass and supporting bone health. Together, these changes may improve metabolic health, reduce strain on the cardiovascular system, and lower several risk factors associated with heart disease.
This information is for educational purposes only and does not replace professional medical advice. Treatment decisions must be made in consultation with a qualified healthcare provider.
Dr GL Vosloo Medical Practice is a registered medical practice managed by BioWell and led by Dr Vosloo, a South African Sports, Exercise, and Lifestyle Physician. The practice operates within the regulatory framework of the HPCSA. All clinical decisions are made by registered medical professionals, and all prescriptions are issued in accordance with applicable medical regulations.
BioWell is a healthcare platform that supports the delivery of structured metabolic health programmes through patient coordination, clinical workflow management, and programme administration. BioWell does not prescribe medication or provide medical advice. All medical treatment is conducted under the supervision of Dr GL Vosloo Medical Practice. Consultations are conducted via the BioWell patient portal at www.bio-well.co.za or by contacting info@bio-well.co.za.
By Dr Gerhard Vosloo, Founder and Head Consulting Practitioner of Dr GL Vosloo Medical Practice, managed by BioWell