Obesity. That was the word, albeit unofficial word, of the day at the recent 2014 Annual Clinical Meeting of the American College of Obstetricians and Gynecologists held in Chicago. I’ve been honored to both attend and have a small role presenting at this meeting for the last two years. For pelvic and maternal health providers and advocates (types like me!), it is an invigorating and educational program addressing a spectrum of reproductive and gynecologic health issues for adolescent girls and women. Reflecting on the 2014 meeting, obesity and its role in female pelvic and maternal health is casting a long shadow.
Let me be clear: This is no exercise in shaming those who are overweight or obese. If anything, it is a call-to-action for providers and patients, alike, to have open and honest dialogue and encourage appropriate and informed care and lifestyle support.
So what is being said in the women’s health care community?
• Obesity is under-diagnosed and undertreated. Physicians at Northshore University Health Systems reported that in their sample of over 63,000 reproductive-aged women, obesity was under-diagnosed and undertreated. Reproductive age was defined as 18-44 years and just over half of the women in the sample were of normal weight (BMI less than 25). This means that nearly half of them were overweight (BMI 25-29.9), obese (BMI 30-39.9), or morbidly obese (BMI greater than 40). Calculate your BMI here.
Granted, this reflects practice patterns in only one health system. However, rates of diagnosis — meaning the physician clearly indicates to the patient that they are overweight/obese/morbidly obese and records this in the health record — range from 4.7% to 47.9%. Similarly, the rate of referral to services to address BMI status were low, just 1-11.7%.
• Rates of women who are obese and pregnant are rising for the first time. This study is based on nationally reported data on over 275 million women. It identified a significant increase in rates of obesity among first-time pregnant women from 2001-2010.
• Pregnant women who are obese commonly gain more than the recommended amount of weight. This is associated with adverse pregnancy outcomes and increased postpartum weight retention.
• Obesity significantly decreases a woman’s chances of successfully breastfeeding. Physicians at the University of Missouri evaluated a population of over 66,000 women who had given birth. They identified that fewer women who were classified as underweight, overweight, and obese had ever breastfed and that obesity significantly reduces breastfeeding rates. This is a non-exhaustive list, for sure.
Remember: they are findings, not judgments. Their intent is to better inform providers so they can, in fact, be better providers and all moms, and their babies, can be healthier as a result.
Published On: May 14, 2014