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, wit h nearly 50% of African-American and Mexican-American women obese. Obe sity significantly increases risk for mortality and morbidity in women , including several gynecological and reproductive disorders and infer tility. Obesity, with the resultant hyperinsulinemia and hyperandrogen emia, negatively affects normal menstrual function and fertility. In a ddition, maternal adiposity may increase risk in offspring through per inatal mechanisms, resulting in a never-ending cycle of obesity. Data suggest that modest weight losses of about 10% of initial weight are e ffective in improving hormonal profiles, menstrual regularity, ovulati on, and pregnancy rates. Available treatments include lifestyle modifi cation programs, with a focus on eating a healthful diet and increasin g physical activity, plus adjunctive pharmacotherapies.