Identifying Stage 1 CKM in a Patient Case

In the third video of this series, PA Viet Le applies the CKM staging framework to a real-world patient case: Maria, a 46-year-old woman with class 1 obesity and no other cardiometabolic comorbidities. He demonstrates how to move beyond obesity classification alone to identify Maria’s CKM stage, using tools like waist circumference and the PREVENT-CVD calculator to refine risk assessment.

PA Le also models how to approach a sensitive conversation about weight with patients, emphasizing a respectful, permission-based approach to shared decision-making.

Key Takeaways:

Any patient with obesity has at least stage 1 CKM.
Stage 1 CKM is an opportunity for early intervention to prevent progression of CKM.
The PREVENT calculator can help us understand an individual’s risk of cardiovascular disease.

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Speaker

Click on the photo below to learn more about the speaker.

Viet Le, DMSc, MPAS, PA-C, FACC, FAHA, HF-Cert

References and Additional Resources:

Alexander L, Christensen SM, Richardson L, et al. Nutrition and physical activity: An Obesity Medicine Association (OMA) Clinical Practice Statement 2022. Obes Pillars. 2022;1:100005. Published 2022 Jan 10. doi:10.1016/j.obpill.2021.100005 https://pubmed.ncbi.nlm.nih.gov/38085928/

American Heart Association. PREVENT^TMOnline Calculator. Accessed July 2, 2026. https://professional.heart.org/en/guidelines-and-statements/prevent-calculator

Bannuru RR; Professional Practice Committee. Weight stigma and bias: standards of care in overweight and obesity-2025. BMJ Open Diabetes Res Care. 2025;13(Suppl 1):e004962. Published 2025 May 16. doi:10.1136/bmjdrc-2025-004962 https://drc.bmj.com/content/13/Suppl_1/e004962

Ndumele CE, Rodriguez F, et al. 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. Published online June 9, 2026. doi:10.1161/CIR.0000000000001453 https://www.ahajournals.org/doi/10.1161/CIR.0000000000001453

Ross R, Neeland IJ, Yamashita S, et al. Waist circumference as a vital sign in clinical practice: a Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity. Nat Rev Endocrinol. 2020;16(3):177-189. doi:10.1038/s41574-019-0310-7 https://pubmed.ncbi.nlm.nih.gov/32020062/

Supported by

Viet Le, DMSc, MPAS, PA-C, FACC, FAHA, HF-Cert

Viet is an Associate Professor of Research and Preventive Cardiology PA at Intermountain Medical Center and co-directs the Preventive Cardiology Clinic. He has a bachelor’s in exercise science/athletic training, trained as a physician assistant at the University of Utah School of Medicine, and obtained his doctorate in Health Professions Education. He is Principal/Sub-Investigator on clinical trials and has authored/co-authored over 80 abstracts and 50 publications. He is past president of the Academy of PAs in Cardiology, past co-chair of the American College of Cardiology PA Work Group, and serves as the President of the Utah Academy of PAs.