*Clinical Instructor, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA; and †Professor and Chair, ‡Associate Professor, Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR.
At just one-third of the American population, those with a normal body mass index are now in the minority in the United States, whereas 68% are overweight or obese. The key to reducing the prevalence of obesity and improving the health of our population is, of course, screening and prevention. Screening (as simple as a weight and height) is effective, inexpensive, and already part of the routine vital signs taken at every visit. However, providers often avoid tackling the issue of weight due to a misperception that treatment is not effective, or from fear of causing offense or compromising rapport. However, clearly more harm is done by not discussing this important health issue. Cardiovascular disease remains the number 1 killer of women, and obesity is the leading modifiable risk factor. Beyond heart disease, obesity has implications for every visit type seen in the OB/GYN office, from contraception to pregnancy to abnormal bleeding to cancer. In addition, maternal obesity adversely affects future generations, making the impact of obesity a never-ending cycle. OB/GYNs are often the only physicians that reproductive-aged women see, and, thus, OB/GYNs have the opportunity to provide a potentially life-altering intervention. Effective treatment is available and includes lifestyle changes, behavioral counseling, medication, and bariatric surgery. Time is always a limitation in a busy practice but becoming more comfortable with how to approach patients, the language to use and tailoring counseling can save time increase impact. Target Audience: Obstetricians And Gynecologists Learning Objectives: After participating in this activity, physicians should be better able to analyze the obesity epidemic and its implications for our patients and the health care system. Evaluate and use the tools for measuring obesity and incorporate obesity screening and education in a busy practice. Formulate effective therapies and determine when to refer patients for psychological or nutrition counseling, addition of weight loss medication or bariatric surgery.