The relationship between body weight and health care among German women.

OBJECTIVE

To investigate the relationship between body weight and the use of health care services among women from southern Germany.

RESEARCH METHODS AND PROCEDURES

Data were drawn from the 1994 to 1995 Monitoring of Trends and Determinants in Cardiovascular Disease Augsburg survey, covering a population-representative sample of women 25 to 74 years old (n = 2301). Logistic regression models were used to calculate odds ratios (ORs) for the use of medical services by women with overweight (BMI 25.0 to 29.9 kg/m(2)) or obesity (BMI >or= 30 kg/m(2)) in comparison with normal-weight women (BMI < 25.0 kg/m(2)).

RESULTS

In multivariable analysis, obese women 50 to 74 years old were more likely than normal-weight women to delay cancer screening procedures, such as manual breast examination and Papanicolaou smear (OR 0.52, 95% confidence interval 0.37 to 0.74) in the previous 12 months. However, the relationship between obesity and cancer screening was not found to be significant in 25- to 49-year-old women (OR 0.92, 95% confidence interval 0.62 to 1.36). Neither in the 25- to 49-year-old age group nor in the 50- to 74-year-old age group were independent relationships between higher body weight and total physician visits, hospitalizations, or medication use observed.

DISCUSSION

Obese women tended to use medical services with greater frequency due to obesity-related diseases. However, postmenopausal women with a BMI >or= 30 kg/m(2) were more likely to delay routine cancer screening, putting them at a greater risk for death from breast, cervical, and endometrial cancer. Thus, obese postmenopausal women should be targeted for increased screening.