Preventing Obesity in Midlife Women: A Recommendation From the Women's Preventive Services Initiative

Chelmow, David; Gregory, Kimberly D.; Witkop, Catherine; Hoffstetter, Susan; Humphrey, Linda L.; Picardo, Carla; Stevermer, James J.; Cantor, Amy; Nelson, Heidi D; Son, Sarah; Conry, Jeanne; García, Francisco José Álvarez; Kendig, Susan; O’Reilly, Nancy; Qaseem, Amir; Ramos, Diana; Salganicoff, Alina; Wood, Julie; Zahn, Christopher M.

doi:10.7326/m22-0252

Cited by 7 publications

(2 citation statements)

References 17 publications

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“…The American Society of Clinical Oncology recommends that public awareness of the link between obesity and cancer be emphasized to help reduce obesity and modify cancer risk ( Ligibel et al, 2017 ). The Women’s Preventive Services Initiative has recently recommended weight management counseling to prevent obesity in midlife women with normal or overweight BMI ( Chelmow, 2022 ). To date, there has not been a national campaign to raise awareness of risk factors for endometrial cancer although there is increasing discussion in the lay media about the rising incidence of endometrial cancer in the United States.…”

Section: Discussionmentioning

confidence: 99%

Higher baseline BMI and lower estimated median income associated with increasing BMI after endometrial cancer diagnosis

Harrington¹,

Balmaceda²,

Spoozak³

et al. 2022

Gynecologic Oncology Reports

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Section: Discussionmentioning

confidence: 99%

Higher baseline BMI and lower estimated median income associated with increasing BMI after endometrial cancer diagnosis

Harrington¹,

Balmaceda²,

Spoozak³

et al. 2022

Gynecologic Oncology Reports

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“…35,36,37 Women's Preventive Services Initiative 2022 recommendations for counseling interventions to prevent weight gain among midlife women also noted the absence of direct evidence that these interventions improve mortality or morbidity. 38,39 A 1997 workshop convened by the National Institutes of Health called for a randomized controlled trial of an intensive lifestyle intervention for intentional weight loss-including behavior modification, diet, and exercise-to provide needed guidance on the risks and benefits of weight loss that could inform rational clinical and public health policy. 40 That trial, known as Look AHEAD, found that an intensive lifestyle intervention focusing on weight loss did produce weight loss and reduce waist circumference but did not reduce the rate of cardiovascular events in adults with type 2 diabetes and overweight or obesity.…”

mentioning

confidence: 99%

Use and Misuse of BMI Categories

2023

AMA Journal of Ethics

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Body mass index (BMI) was introduced in the 19th century as a measure of weight relative to height. Before the late 20th century, overweight and obesity were not considered a population-wide health risk, but the advent of new weight loss drugs in the 1990s accelerated the medicalization of BMI. A BMI category labeled obesity was adopted in 1997 by a World Health Organization consultation and subsequently by the US government. Language in the National Coverage Determinations Manual stating that "obesity itself cannot be considered an illness" was removed in 2004, allowing reimbursement for weight loss treatments. In 2013, the American Medical Association declared obesity to be a disease. Yet the focus on BMI categories and on weight loss has yielded few health benefits and contributes to weight-related discrimination and other potential harms.An Important Clinical Problem? Dramatic statements about the health risks of obesity are common today. The opening lines of a recent article read: "Obesity is the most prevalent chronic disease worldwide, affecting approximately 650 million adults. Excess adiposity and its numerous complications, including cardiovascular disease and type 2 diabetes, impose a considerable economic burden and constitute major contributors to global morbidity and mortality." 1 Such assertions are a recent development. According to the Institute of Medicine, "Prior to the late 20th century, overweight and obesity were not considered a population wide health risk." 2 Body weight was often considered as more of a cosmetic and social issue than an important medical concern. 3 A 1969 study found that patients and physicians did not view body weight and weight loss as salient medical problems and considered deviations from weight standards to be almost meaningless. 4 Prior to 2004, the National Coverage Determinations Manual stated bluntly that "obesity itself cannot be considered an illness," 5 and treatment for obesity was not covered by Medicare. 5 The costs of weight loss as a treatment for obesity were not allowed as a medical deduction for tax purposes until 2002. 6 Until the 2010s, in most doctor visits, BMI was not calculated. 7

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