Management of obesity across women's life course: FIGO Best Practice Advice

Author:

Maxwell Cynthia V.1,Shirley Rachelle2,O'Higgins Amy C.2,Rosser Mary L.3,O'Brien Patrick4,Hod Moshe56,O'Reilly Sharleen L.78,Medina Virna P.9,Smith Graeme N.10,Hanson Mark A.1112,Adam Sumaiya1314,Ma Ronald C.1516,Kapur Anil17,McIntyre Harold David18,Jacobsson Bo1920,Poon Liona C.21,Bergman Lina222324,Regan Lesley25,Algurjia Esraa2627,McAuliffe Fionnuala M.7,

Affiliation:

1. Maternal Fetal Medicine; Sinai Health and Women's College Hospital University of Toronto Toronto Ontario Canada

2. Maternal Fetal Medicine, Sinai Health University of Toronto Toronto Ontario Canada

3. Department of Obstetrics and Gynecology Columbia University Irving Medical Center, New York‐Presbyterian New York New York USA

4. Institute for Women's Health University College London London UK

5. Helen Schneider Hospital for Women Rabin Medical Center Petah Tikva Israel

6. Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel

7. UCD Perinatal Research Centre, School of Medicine University College Dublin, National Maternity Hospital Dublin Ireland

8. School of Agriculture and Food Science University College Dublin Dublin Ireland

9. Department of Obstetrics and Gynecology Faculty of HealthUniversidad del Valle, Clínica Imbanaco Quirón Salud, Universidad Libre Cali Colombia

10. Department of Obstetrics and Gynecology, Kingston Health Sciences Centre Queen's University Kingston Ontario Canada

11. Institute of Developmental Sciences University Hospital Southampton Southampton UK

12. NIHR Southampton Biomedical Research Centre University of Southampton Southampton UK

13. Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences University of Pretoria Pretoria South Africa

14. Diabetes Research Centre, Faculty of Health Sciences University of Pretoria Pretoria South Africa

15. Department of Medicine and Therapeutics The Chinese University of Hong Kong Hong Kong SAR China

16. Hong Kong Institute of Diabetes and Obesity The Chinese University of Hong Kong Hong Kong SAR China

17. World Diabetes Foundation Bagsvaerd Denmark

18. Mater Health University of Queensland, Mater Health Campus South Brisbane Queensland Australia

19. Department of Obstetrics and Gynecology Sahlgrenska University Hospital/Ostra Gothenburg Sweden

20. Department of Genetics and Bioinformatics Domain of Health Data and Digitalisation, Institute of Public Health Oslo Norway

21. Department of Obstetrics and Gynecology, Prince of Wales Hospital The Chinese University of Hong Kong Shatin, Hong Kong SAR China

22. Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden

23. Department of Obstetrics and Gynecology Stellenbosch University Cape Town South Africa

24. Department of Women's and Children's Health Uppsala University Uppsala Sweden

25. Imperial College London London UK

26. The World Association of Trainees in Obstetrics & Gynecology Paris France

27. Elwya Maternity Hospital Baghdad Iraq

Abstract

AbstractObesity is a chronic, progressive, relapsing, and treatable multifactorial, neurobehavioral disease. According to the World Health Organization, obesity affects 15% of women and has long‐term effects on women's health. The focus of care in patients with obesity should be on optimizing health outcomes rather than on weight loss. Appropriate and common language, considering cultural sensitivity and trauma‐informed care, is needed to discuss obesity. Pregnancy is a time of significant physiological change. Pre‐, ante‐, and postpartum clinical encounters provide opportunities for health optimization for parents with obesity in terms of, but not limited to, fertility and breastfeeding. Pre‐existing conditions may also be identified and managed. Beyond pregnancy, women with obesity are at an increased risk for gastrointestinal and liver diseases, impaired kidney function, obstructive sleep apnea, and venous thromboembolism. Gynecological and reproductive health of women living with obesity cannot be dismissed, with accommodations needed for preventive health screenings and consideration of increased risk for gynecologic malignancies. Mental wellness, specifically depression, should be screened and managed appropriately. Obesity is a complex condition and is increasing in prevalence with failure of public health interventions to achieve significant decrease. Future research efforts should focus on interprofessional care and discovering effective interventions for health optimization.

Publisher

Wiley

Subject

Obstetrics and Gynecology,General Medicine

Reference123 articles.

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2. Obesity Medicine Association.Obesity Algorithm. 2021.https://obesitymedicine.org/wp‐content/uploads/2021/08/2021‐Obesity‐Algorithm‐PowerPoint.pdf. Accessed July 5 2022.

3. Centers for Disease Control and Prevention [website].Vital signs. Medical complications of obesity. How does obesity affect the body.https://www.cdc.gov/vitalsigns/adultobesity/infographic.html. Accessed November 1 2022.

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5. World Health Organization.The Global Health Observatory [website]. Prevalence of obesity among adults BMI >= 30 (age‐standardized estimate) (%).https://www.who.int/data/gho/data/indicators/indicator‐details/GHO/prevalence‐of‐obesity‐among‐adults‐bmi‐=‐30‐(age‐standardized‐estimate)‐(−). Accessed July 5 2022.

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