Obesity in Women presentation by Catherine Spong, MD

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2012 Dialogue presentation by Catherine Spong, MD – Branch Chief, National Institute of Child Health & Human Development

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  • Over 60 percent of U.S. adult women are overweight, according to 2007 estimates from the National Center for Health Statistics of the Center for Disease Control and Prevention. Just over one-third of overweight adult women are obese.
  • Look at how the national trend in obesity has progressed over the past 15 years. The CDC compiles this data on an annual basis, so back in 1996 every state in the union had <20% of obesity. Over the subsequent 15 years, every single state now has >20% and many are >30.
  • As the US population becomes increasingly obese while smoking rates continue to decline, obesity has overtaken smoking as the leading contributor to the burden of disease and shortening of healthy life in the U.S. L W. Rice, M.D.
  • Obesity in Women presentation by Catherine Spong, MD

    1. 1. Catherine Y Spong, MD Associate Director Extramural ResearchEunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) National Institutes of Health (NIH)
    2. 2. Ihave no conflict of interest related to this presentationIhave no relevant financial relationships with any commercial interest relative to the subject of this lecture
    3. 3. Obesity: excess of body fatCommon Methods Body Mass Index Body circumference: ◦ Waist <85cm or < 35” for women) Waist to hip ratio: >.91
    4. 4. Online BMI calculator: www.nhlbisupport.com/bmi Weight (Kg)Body Mass Index: (BMI) Height (m)2• Overweight BMI >25 – 29.9• Obese BMI >30 obesity class I BMI 30 -34.9 obesity class II BMI 35 -39.9 obesity class III BMI >40 WHO 2000 and NIH
    5. 5.  Obesity is the fastest-growing cause of disease and death in USA Over 60% U.S. adult women are overweight Over 1/3 of overweight adult women are obese The World Bank has estimated the cost of obesity in the U.S. at 12% of the National Health Care budget
    6. 6.  30% of reproductive age women are obese Additional 25% are overweight There has been a 70% increase in the proportion of women who are obese at the beginning of pregnancy IOM 2009 Flegal 2010 JAMA 303:233-41 Kulte et al J Am Board Fam Med 2011;24:75-85
    7. 7.  34 million Americans are overweight Increase from 1 in 8 (1991) to 1 in 5 (1998) are obese Women are generally at increased risk Racial distribution (women): ◦ 45% Black ◦ 35% Hispanic ◦ 25% White ◦ 45% American Indian
    8. 8. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%
    9. 9. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%
    10. 10. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)No Data <10% 10%–14% 15%–19% ≥20%
    11. 11. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)No Data <10% 10%–14% 15%–19% ≥20%
    12. 12. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)No Data <10% 10%–14% 15%–19% ≥20%
    13. 13. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
    14. 14. Obesity Trends* Among U.S. Adults BRFSS, 2002 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
    15. 15. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
    16. 16. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
    17. 17. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
    18. 18. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
    19. 19. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
    20. 20. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
    21. 21. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
    22. 22. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
    23. 23.  Hypertension  Degenerative Joint Type II Diabetes Disease  Gout Hyperlipidemia  Gallstones and Kidney Coronary Heart Disease Stones Cancer:  Gastric Reflux ◦ Endometrial  Sleep apnea ◦ Breast  Increased surgical risks ◦ Colon  Depression
    24. 24.  Gynecologic Implications ◦ Infertility ◦ Menstrual Irregularities ◦ Ovulation problems ◦ Reproductive Cancers ◦ Metabolic Syndrome
    25. 25. Jai & Lubetkin, Am J Prev Med 2010;38(2):138 –144.
    26. 26.  Weight reduction of 5-7 % associated with: ◦ Lower blood pressure ◦ Improved cholesterol ◦ Lower risk of developing diabetesTreatment must involve - Multidisciplinary, culturally appropriate approach as for most chronic diseases - Focus on prevention especially at critical points such as childhood, pregnancy and menopause
    27. 27.  Obesity rates are rising, reaching concerning levels in women and children Impact on women’s health is dramatic ◦ reproductive ◦ long-term Role of technology and lifestyle Complex as a health issue ◦ Solutions require diverse perspectives
    28. 28. The goal: healthy mothers, healthy children, healthy families…

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