Cholesterol risk isn’t about weight alone—genetics and fat intake matter

High LDL cholesterol raises heart attack and stroke risk, but being lean doesn’t guarantee safety; genetics and saturated-fat intake largely drive LDL levels. Obesity mainly affects other lipids (triglycerides and remnant cholesterol) and is linked to diabetes and high blood pressure, which can make LDL more harmful. Overall cardiovascular risk isn’t determined by LDL alone, so a clinician should assess it—consider NHS checks from age 40 and family history of early heart disease.