Lifestyle: Weight                                            

Women should be counseled on the grave impact their weight has on their overall health and longevity, including their fertility and reproductive future.

The data for effects on pregnancy are less well described for overweight; however, overweight has been clearly described as a risk factor for future obesity, so the same counseling is indicated.

Obesity can no longer accurately be described as an “epidemic,” which connotes a serious but transient event. Instead, obesity is now termed “endemic” in the U.S. and many developed nations and doesn’t seem to be going anywhere.

According to the most recent NHANES report (1990), approximately one third of women, including reproductive age women, in the U.S. are obese, and the risks to their reproductive future are many. Intervention in the preconception period is necessary in the care of reproductive age women.

Definitions: Normal weight is defined by BMI as 18.5-24.9 kg/m2. Overweight is 25-29.9. Obesity is defined as having a BMI > 30 kg/m2 and is now further stratified into Class I (30-34.9), Class II (35-39.9), and Class III/extreme obesity (>40).

Being obese is not only usually an unpleasant experience for the patient, but also seriously jeopardizes the health and future health of the patient. Obesity increases the risk of almost every unfavorable medical event, and these relationships are well described and known: hypertension, type II diabetes, heart disease, respiratory impairment, sleep apnea, gallbladder disease, many types of cancer (breast, uterine, colon), osteoarthritis, etc.