Impact of obesity on women's health

Lash, Marcy Maguire; Armstrong, Alicia

doi:10.1016/j.fertnstert.2008.02.141

Cited by 87 publications

(73 citation statements)

References 38 publications

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“…Obese girls frequently experience the onset of puberty at a younger age than their normal-weight peers. 37 Between the late 1960s and 1990, during a time of increasing prevalence of childhood obesity, the median age of menarche decreased by approximately 3 months in white girls and 5.5 months in black girls in the United States. 37 Obesity negatively affects contraception.…”

Section: Obesity and Infertility (Including Polycystic Ovary Syndrome)mentioning

confidence: 99%

“…37 Between the late 1960s and 1990, during a time of increasing prevalence of childhood obesity, the median age of menarche decreased by approximately 3 months in white girls and 5.5 months in black girls in the United States. 37 Obesity negatively affects contraception. Older studies have shown that hormonal contraception methods are less effective in obese women.…”

Section: Obesity and Infertility (Including Polycystic Ovary Syndrome)mentioning

confidence: 99%

“…Older studies have shown that hormonal contraception methods are less effective in obese women. 37 For example, a retrospective cohort analysis of 2822 person-years of oral contraceptive use suggested that women in the highest quartile of body weight (Ն70.5 kg) had a 60% higher risk of failure than women of lower weight. This study also found that the increased risk of failure associated with weight was higher for women using very low-dose or lowdose oral contraceptives.…”

Section: Obesity and Infertility (Including Polycystic Ovary Syndrome)mentioning

confidence: 99%

“…38 Additionally, a study of 1005 women using the levonorgestrol vaginal ring demonstrated higher rates of pregnancy at 1 year for heavier patients (1.7% for a 40-kg woman; 9.8% for an 80-kg woman). 37 Obesity is a risk factor for technical failure of tubal ligation surgery (OR, 1.7; 95% CI, 1.2-2.6). 40 The intrauterine device may be one of the few reliable contraception options whose efficacy does not seem to be affected by BMI.…”

Section: Obesity and Infertility (Including Polycystic Ovary Syndrome)mentioning

confidence: 99%

“…40 The intrauterine device may be one of the few reliable contraception options whose efficacy does not seem to be affected by BMI. 37 Product inserts rarely comment on weight-specific guidelines (Table 4). Although most attention has focused on the impact of obesity on ovulation, other studies suggest a multifactorial impact.…”

Section: Obesity and Infertility (Including Polycystic Ovary Syndrome)mentioning

confidence: 99%

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Obesity and Women's Health: An Evidence-Based Review

Kulie¹,

Slattengren²,

Redmer³

et al. 2011

The Journal of the American Board of Family Medicine

280

181

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Obesity negatively impacts the health of women in many ways. Being overweight or obese increases the relative risk of diabetes and coronary artery disease in women. Women who are obese have a higher risk of low back pain and knee osteoarthritis. Obesity negatively affects both contraception and fertility as well. Maternal obesity is linked with higher rates of cesarean section as well as higher rates of highrisk obstetrical conditions such as diabetes and hypertension. Pregnancy outcomes are negatively affected by maternal obesity (increased risk of neonatal mortality and malformations). Maternal obesity is associated with a decreased intention to breastfeed, decreased initiation of breastfeeding, and decreased duration of breastfeeding. There seems to be an association between obesity and depression in women, though cultural factors may influence this association. Obese women are at higher risk for multiple cancers, including endometrial cancer, cervical cancer, breast cancer, and perhaps ovarian cancer. The prevalence of obesity is rising. The World Health Organization estimates that more than 1 billion people are overweight, with 300 million meeting the criteria for obesity. 1 Twenty-six percent of nonpregnant women ages 20 to 39 are overweight and 29% are obese. 2 This article will review the wide-ranging effects that obesity has on both reproductive health and chronic medical conditions in women.A PubMed search was performed using the key words "obesity," "overweight," "body mass index" (BMI), "gender," "women's health," and the condition reviewed. The most recent evidence-based articles were included in the review. The evidence level of each article was determined by the authors based on the type of study, randomization, the number of participants, and loss to follow-up. Table 1 provides a classification for overweight and obesity based on BMI. 3 Waist circumference can also be used to classify overweight and obesity. In women, a waist circumference of Ͼ35 inches (88 cm) is high risk, whereas in men the level is Ͼ40 inches (102 cm). Research varies in the measurements of obesity used to classify participants in each study. Obesity and Type 2 Diabetes MellitusThe risk of diabetes mellitus (DM) increases with the degree and duration of being overweight or obese and with a more central or visceral distribution of body fat. Increased visceral fat enhances the degree of insulin resistance associated with obesity. 4 In turn, insulin resistance and increased visceral fat are the hallmarks of metabolic syndrome, an assembly of risk factors for developing diabetes and cardiovascular disease. 4 -6 The Nurses' Health Study followed 84,000 female nurses for 16 years and found that being overweight or obese was the single most important predictor of DM. 7 An increased risk of DM was seen in women with BMI values Ͼ24 and a waistto-hip ratio Ͼ0.76. 8 After adjusting for age, family history of diabetes, smoking, exercise, and several This article was externally peer reviewed.

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Section: Obesity and Infertility (Including Polycystic Ovary Syndrome)mentioning

confidence: 99%

Section: Obesity and Infertility (Including Polycystic Ovary Syndrome)mentioning

confidence: 99%

Section: Obesity and Infertility (Including Polycystic Ovary Syndrome)mentioning

confidence: 99%

Section: Obesity and Infertility (Including Polycystic Ovary Syndrome)mentioning

confidence: 99%

Section: Obesity and Infertility (Including Polycystic Ovary Syndrome)mentioning

confidence: 99%

See 3 more Smart Citations

Obesity and Women's Health: An Evidence-Based Review

Kulie¹,

Slattengren²,

Redmer³

et al. 2011

The Journal of the American Board of Family Medicine

280

181

View full text Add to dashboard Cite

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Preconception and Early-Pregnancy Body Mass Index in Women and Men, Time to Pregnancy, and Risk of Miscarriage

Boxem,

Blaauwendraad,

Mulders

et al. 2024

JAMA Netw Open

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ImportanceObesity in women is associated with reduced fertility and an increased risk of miscarriage. These associations might also be present across the full range of body mass index (BMI) categories as well as among men.ObjectiveTo investigate the associations of preconception BMI in both partners with time to pregnancy and miscarriage.Design, Setting, and ParticipantsThis population-based prospective cohort study was conducted in Rotterdam, the Netherlands, between August 9, 2017, and July 1, 2021. A total of 3604 women and their partners were included from the preconception period onward with follow-up until birth. The date of analysis was July 12, 2024.ExposureBody mass index (calculated as weight in kilograms divided by height in meters squared) measured in preconception or early pregnancy.Main Outcome and MeasuresFecundability, defined as the probability of conceiving within 1 month; subfertility, defined as time to pregnancy or duration of actively pursuing pregnancy of more than 12 months or use of assisted reproductive technology; and miscarriage, defined as pregnancy loss before 22 weeks of gestation. These measures were assessed using questionnaires and via the obstetric caregiver.ResultsThe study population for time-to-pregnancy analyses consisted of 3033 episodes among women (median age, 31.6 years [IQR, 29.2-34.5 years]; median BMI, 23.5 [IQR, 21.2-26.5]) and 2288 episodes among men (median age, 33.4 years [IQR, 30.5-36.8 years]; median BMI, 24.9 [IQR, 23.0-27.4]). The study population for miscarriage analyses consisted of 2770 pregnancy episodes among women (median age, 31.5 years [IQR, 28.9-34.3 years]; median BMI, 23.5 [IQR, 21.3-26.7]) and 2189 pregnancy episodes among men (median age, 33.5 years [IQR, 30.4-36.8 years]; median BMI, 25.0 [IQR, 23.0-27.5]). Higher BMI in women and men was associated with lower fecundability: for every unit increase in BMI, fecundability decreased (fecundability ratio [FR]: women, 0.98 [95% CI, 0.97-0.99]; men, 0.99 [95% CI, 0.98-1.00]). Women with overweight (FR, 0.88 [95% CI, 0.80-0.98]) and obesity (FR, 0.72 [95% CI, 0.63-0.82]) had lower fecundability compared with women with normal weight. Compared with normal weight in women, underweight (odds ratio [OR], 1.88 [95% CI, 1.22-2.88]), overweight (OR, 1.35 [95% CI, 1.11-1.63]), and obesity (OR, 1.67 [95% CI, 1.30-2.13]) were associated with increased odds of subfertility. In men, obesity was associated with increased odds of subfertility (OR, 1.69 [95% CI, 1.24-2.31]). Compared with normal weight in women, overweight (OR, 1.49 [95% CI, 1.12-1.98]) and obesity (OR, 1.44 [95% CI, 1.00-2.08]) were associated with increased odds of miscarriage.Conclusions and RelevanceIn this cohort study, BMI outside of the normal category in women and men during the preconception or early-pregnancy periods was associated with time to pregnancy and miscarriage. Optimizing BMI in women and men from the preconception period onward might be an important strategy to improve fertility outcomes.

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