Objective: Risk score models and the diagnosis of a metabolic syndrome are useful for cardiovascular (CV) risk prediction. The identification of individuals with high CV and metabolic risk is essential to provide appropriate prevention and therapy. The present study aims at clarifying whether these indicators are altered by a weight reduction programme. Additionally, which diagnostic tool has a better predictive value is examined. Method: One hundred and twenty overweight and obese subjects aged 30 60 years were included in a 12-week weight reduction programme. The CV risk was assessed by means of German multiple-used risk charts (SCORE) at baseline and at the end of the trial. Furthermore, the prevalence of the metabolic syndrome (three out of five risk factors) was quantified. Results: The initial prevalence of the metabolic syndrome was 63.3% (n = 76) and decreased to 41.7% (n = 50) by the end of the intervention. The SCORE also decreased significantly after twelve weeks (p < 0.001). The percentage of subjects at high risk (SCORE > 5%) was comparatively low (t0: 7.4%, n = 7; t12: 5.3%, n = 5). Conclusion: The weight reduction concept was applicable to improve the CV risk SCORE and decrease the prevalence of the metabolic syndrome. The CV 10-year risk calculated using German risk charts (SCORE) probably underestimated the risk of CV diseases in this collective. In this case, the diagnosis of a metabolic syndrome is more meaningful than risk SCORE calculations.