Focus on primary care: evaluation, management, and treatment of obesity in women.

Abstract

Obesity is the number one nutritional disorder in the developed world. It is now well recognized that obesity is a disease that represents a rapidly growing epidemic. It is often a lifelong problem that preferentially affects women. Modern science and medicine are just beginning to unravel the multifactorial pathophysiology of obesity. Current literature emphasizes the metabolic, hormonal, and behavioral interactions as well as genetic predisposition. This understanding has led to new recommendations for the management of the obese patient and to new pharmaceutical approaches for those at high risk. These risks include diabetes, cardiovascular disease, hypertension, gallbladder disease, and osteoarthritis. In addition, there are a number of reproductive health problems unique to obese women. Until recently, however, the evidence for benefit of weight loss was not clear. There are now numerous Category A data indicating significant benefit for weight loss as it affects multiple comorbidities It is, therefore, incumbent upon the providers of women's health care to assess patient risk and to offer resources, guidance, assistance, and reassurance to the overweight and obese patient as she embarks on a program of renewed health through weight loss. After completion of this article, the reader will be able to describe the classification of overweight and obesity, explain the pathophysiology of obesity, outline the evaluation and screening of the obese patient, and list potential therapeutic interventions for weight loss.