In the last few years, the longevity of Americans has fallen for the first time in our history. Obesity has mushroomed, heart disease still kills approximately 600,000 Americans and stroke 150,000. This review will cover the 8 most important non-genetic risk factors for heart disease and stroke. Meanwhile, recent research has clarified the root cause of atherosclerosis. The approval of tirzepatide to treat obesity in November 2023 by the FDA turns out to have enormous implications for medicine and surgery and the food industry.