About 650 million persons are diagnosed as obese globally. Nonetheless, managing obesity in women is usually different from that in men. This premise is explored by a latest paper published within the Journal of Progress in Cardiovascular Diseases, which provides a women’s health perspective on obesity.

Study: A Women’s health perspective on managing obesity. Image Credit: JacobLund/Shutterstock.com

Introduction

The researchers present a holistic consideration of the condition and its management against the background of female physiology. Such recognition could pave the best way for higher prevention and treatment of female obesity.

Little is thought in regards to the differential aspects in male vs. female obesity. The consequences of sex, ethnicity, and comorbidities should be further explored.

Nonetheless, several hypotheses have been raised surrounding the observed differences between the sexes relating to weight gain.

These include weight gain related to female life stages, namely, puberty, pregnancy, and menopause when enormous changes in female sex hormones occur. The consequences of age are exacerbated by reduced ovarian function and increased androgen production in perimenopause.

Neural and behavioral aspects are also postulated to affect women’s greater response to calorie-dense foods, especially those high in carbohydrates.

Measuring body fat

Body mass index (BMI) is essentially the most common benchmark for diagnosing obesity.

As described by many researchers, nevertheless, the BMI fails on many counts. Not only is it unable to tell apart lean from fat body mass, however it also doesn’t take race and sex differences under consideration, nor does it leave room to accommodate differences in bone density.

These are critical in differentiating healthy body mass from unhealthy and contribute to pushing a big proportion of the population into the obesity zone, albeit falsely. Other measures just like the waist circumference and waist-to-hip ratio also fail to tell apart visceral fat mass from other body components.

More accurate methods like dual-energy x-ray absorptiometry (DEXA) can be found to evaluate body fat mass directly but aren’t cost-effective in a clinical scenario. Digital anthropometry may fill the gap, but further studies must confirm it as an inexpensive alternative.

Diagnosing obesity

How can the problems mentioned above be remedied? The paper suggests a comprehensive assessment of the person as step one. This begins, as at all times, with a history focused on periods of weight gain, aspects that drove weight gain, including dietary aspects, physical exertion, and medications and life events. The impact of pregnancy and menopause are crucial amongst women, as is the family history.

Sleep and stressor history can also be essential, in addition to the socioeconomic environment which frequently forces unhealthy food selections on the person and/or family.

Medications like steroids, often utilized in chronic inflammatory conditions, antihistamines, and anti-psychotics, are related to metabolic alterations resulting in weight gain.

Finally, psychological conditions similar to bulimia and night-eating syndrome also occur ceaselessly in obese patients and require specific interventions to enhance their mental health.

Such an assessment…

…recognizes that obesity isn’t merely attributable to a person’s selections (i.e., eating regimen, amount of exercise, or willpower)”…

…thus reducing social stigma related to obesity and providing healthy ways to maneuver ahead.

The way to treat female obesity?

Considering the breadth of things affecting female obesity, its treatment should be equally multifactorial and tailored to the person patient and cultural surroundings. Financial well-being is equally essential, as is the sustainability of the intervention plan.

As an illustration, an entire medication review is indicated to weed out, substitute, or complement those who induce or encourage obesity.

Lifestyle therapies are the linchpin of weight reduction efforts, with adjunctive medical or surgical interventions as required. Dietary advice and support are crucial to permit the patient to adapt to a nourishing but non-obesogenic pattern of food intake.

Physical activity helps prevent weight gain but cannot often advertise. Nonetheless, when conjoined with a dietary program, it builds cardiovascular fitness, improves physical function, and boosts energy expenditure, thus helping maintain a stable weight.

It is crucial to discover and proper sleep disorders, and diseases like gastro-esophageal reflux disease (GERD) and depression, or asthma, that contribute to obesity and intensity its morbid effects.

Stress relief also needs to be an element of the intervention since each external stressors and weight stigma may oppose the success of weight-loss efforts.

Pharmacotherapy is restricted to those with failed weight-loss goals using only lifestyle therapy, provided the patient isn’t lactating and is obese or chubby with related disease conditions. Several approved medications are in use at present for long-term use. Just a few other anti-diabetic medications are used off-label for a similar purpose.

Bariatric surgery is an alternative choice for such patients, with most procedures involving removing the foremost a part of the stomach and diverting the gastric contents to bypass a part of the small intestine, promoting malabsorption.

These are highly effective in producing acute severe weight reduction, but their long-term effects are less certain, and their use is related to malnutrition, micronutrient deficiency, and acid reflux disorder.

Pregnancy is a special risk factor for obesity in women, and vice versa. Pregnancies in women with excessive weight could also be complicated by fetal anomalies, large babies, preterm birth, stillbirth, gestational diabetes, and pre-eclampsia. The latter may persist or arise unusually early in later life as well.

Women who’re already chubby or obese before pregnancy should shed pounds at this point via lifestyle strategies to optimize their possibilities of a healthy pregnancy.

Ovulatory disorders like anovulatory polycystic ovarian syndrome are sometimes corrected or benefited, and the efficacy of assisted reproductive technologies (ART) is usually improved by weight reduction.

Nonetheless, intensive support is required to keep up pre-pregnancy weight reduction throughout pregnancy. About 50% of girls experience excessive weight gain while pregnant, which carries forward into later life.

Again, about three-quarters of pregnant women retain the load they gained into the primary 12 months postpartum, with a mean gain of 4-5 kg at one 12 months.

Exclusive breastfeeding and psychological support may mitigate such retention, which is related to long-term weight issues, heart problems, type 2 diabetes and endometrial/breast cancer, irregular menstrual cycles, and fertility issues, besides pelvic floor disorders.

Physical activity is thought to enhance maternal well-being but requires social support, normally, to change into an element of life.

What are the implications?

Multiple causes may underlie female weight gain resulting in obesity and related comorbidities.

Obesity in women may increase the chance of heart problems, especially after menopause which is itself a cardiovascular risk factor for girls of all body weights.

From a biological perspective, the treatment of obesity in women is different in contrast to men and varies accordingly to the girl’s age and stage of development.”

This could drive the framing of interventions to shed pounds and keep it off while successfully navigating the varied life stages in a lady’s lifespan. Future steps also needs to explore disparities in obesity rates and treatment options in high-prevalence sections of the population.