Obesity
Now the # 1 issue in Women’s health.
ACOG NEWS RELEASE
| For Release: | September 30, 2005 |
| Contact: | ACOG Office of Communications |
| (202) 484-3321 | |
| communications@acog.org |
Washington, DC — The sharp increase in obesity in the US prompts The American College of Obstetricians and Gynecologists (ACOG) to recommend evaluating all women for obesity. With approximately one-third of US women classified as obese—defined as a Body Mass Index (BMI) greater than 30—obesity is the fastest growing health problem in the US. It is viewed within the ob-gyn specialty as one of the leading health problems confronting women today.
The new ACOG Committee Opinion, titled “The Role of the Obstetrician-Gynecologist in the Assessment and Management of Obesity,” addresses obesity in the nonpregnant adult woman. ACOG recommends that ob-gyns evaluate all women for obesity by calculating their BMI and offering appropriate interventions or referrals. It is the second document on obesity issued by ACOG in as many months. In September, ACOG released guidelines on obesity in pregnant women.
“Obesity in women is a serious health epidemic in this country. It’s time for ob-gyns to discuss weight issues with their patients,” says Vivian M. Dickerson, MD, immediate past president of ACOG, who made obesity a focus of the organization during her presidency. “While the topic may make us uncomfortable, in that we feel we may offend our patients, we should take a more direct approach in helping to identify their health risks. Ob-gyns, after all, serve as primary care physicians for most women. If our specialty doesn’t broach this subject with women, who will? This document offers guidance on how to do just that,” she adds.
Obesity is associated with increased health problems, including type 2 diabetes, hypertension, infertility, heart disease, gallbladder disease, osteoarthritis, and a variety of cancers, including breast, uterine, and colon cancers. In addition, obese women are five times more likely than nonobese women to develop endometrial cancer.
The Committee Opinion calls on ob-gyns to review a patient’s medical, social, and family history for weight-related conditions and calculate each patient’s BMI. If a patient’s BMI is greater than 30, the severity of obesity (class I, II, or III) should be noted. Central adiposity, defined as a waist circumference of greater than 35 inches in women, may identify women with additional health risks.
Among the other ACOG recommendations:
- Reinforce the importance of weight loss and exercise and assess the patient’s readiness to make behavioral changes as an initial approach;
- Inform the patient in a sensitive manner that her weight is a health concern and assist her in developing a weight loss and exercise plan;
- Ask the patient whether she is concerned about her weight and has ever tried to lose weight, which will help determine whether the patient is interested in weight management; and
- Refer the patient for further evaluation and treatment whenever the resources of the clinician are insufficient to meet the needs of patients with a BMI of 40 or greater or a BMI of 35 or greater with comorbidities who have failed appropriate prior intervention(s).
The document also addresses the use of the two most studied weight loss drugs: orlistat, marketed as Xenical®, and sibutramine, marketed as Meridia®, both of which have been approved by the US Food and Drug Administration for patients with a BMI of 30 or greater or with a BMI of 27 or greater plus other risk factors.
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The American College of Obstetricians and Gynecologists is the national medical organization representing over 49,000 members who provide health care for women.