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.