Obesity: a never-ending cycle?

Obesity is the number one public health concern in the United States, affecting over one-third of women. Minorities are at highest risk, with nearly 50% of African-American and Mexican-American women obese. Obesity significantly increases risk for mortality and morbidity in women, including several gynecological and reproductive disorders and infertility. Obesity, with the resultant hyperinsulinemia and hyperandrogenemia, negatively affects normal menstrual function and fertility. In addition, maternal adiposity may increase risk in offspring through perinatal mechanisms, resulting in a never-ending cycle of obesity. Data suggest that modest weight losses of about 10% of initial weight are effective in improving hormonal profiles, menstrual regularity, ovulation, and pregnancy rates. Available treatments include life-style modification programs, with a focus on eating a healthful diet and increasing physical activity, plus adjunctive pharmacotherapies.