WELCOME

Introduction

Asthma

Cancer

Diabetes

Heart disease
and Stroke

Obesity

Nutrition

Physical
Activity

Tobacco
Use

Appendixes

In the past 10 years, obesity rates have increased
by more than
60 percent among adults.  Nearly 50
million adults
are obese.

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Regular
physical activity is a key part
of any weight loss effort.
It’s also
important in maintaining a healthy weight.

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The total cost attributable to obesity-related diseases in the United States is nearly $100 billion annually.

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The higher a woman's BMI is above 25,
the greater are her weight-related health risks.

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Obesity

Many diseases are associated with overweight and obesity. Women, especially women of color, who are overweight or obese are at increased risk for high blood pressure, type 2 diabetes, coronary heart disease (CHD), stroke, gallbladder disease, osteoarthritis, sleep apnea, respiratory problems, and some types of cancer. The health outcomes related to these diseases, however, often can be improved through weight loss or, at a minimum, no further weight gain.¹

Overweight and obesity affect a large proportion of the total U.S. population.  Obesity has been called a true epidemic. 
In 1999-2000, 64 percent of adults were overweight, compared to 56 percent when surveyed in 1988-1994; 30 percent of adults were obese, an increase from 23 percent.²   Continued increases have been reported although the most recent data are self-reported.³

Overweight and obesity are observed in all population groups, but obesity is particularly common among Hispanic, African American, American Indian/Alaska Native, and Pacific Islander women. Fifty percent of adult African American women are obese.  Obesity is high in Mexican American and American Indian/Alaska Native women. In one specific

population in Arizona, a study found that 80 percent of American Indians were overweight. Being overweight is a problem for Pacific Islanders. Native Hawaiians and Samoans are among the most obese people in the world.⁴

As shown in the chart Percentage of Women Overweight or Obese, racial and ethnic differences among women are substantial.² As found in the latest National Health and Nutrition Examination Survey, obesity and overweight were highest among non-Hispanic black women. More than half of non-Hispanic black women aged 40 years or older were obese, and more than 80 percent were overweight.²

As the chart Percentage of Women Who Are Obese by Age shows, age matters.  Women over age 60 are approaching the halfway mark in terms of how many are obese.³

The U.S. Department of Health and Human Services (HHS) is attacking the problem on many fronts.  The Steps to a HealthierUS initiative, the foundation for this special women’s health section, is promoting good nutrition and physical activity to prevent obesity and other chronic conditions. Obesity-related research and education projects are under way at the Agency for Healthcare Research and Quality, Indian Health Service, Centers for Disease Control and Prevention, Food and Drug Administration (FDA), National Institutes of Health (NIH), Health Resources and Services Administration, and the Office of the Surgeon General.

HHS collaborates with the U.S. Department of Agriculture in promoting the Dietary Guidelines for Americans. The guidelines provide authoritative advice about how good dietary habits can promote health and reduce risk for major chronic diseases.

The FDA Obesity Working Group released its final report and recommendations in February 2004.⁵  The group’s findings and recommendations were realistic but hopeful that consumers will lead healthier lives through better nutrition.  The group summarized the problem of obesity as having “no single cause. Rather, it is the result of numerous factors acting together over time.  Similarly, there will be no single solution; obesity will be brought under control only as a result of numerous coordinated, complementary efforts from a variety of sectors of society. Nor can this problem be solved quickly.  Any long-lasting reversal of this phenomenon will itself be a long-term process.”

Of particular interest to women are the working group’s recommendations for dietary guidelines (have a carrot, not the carrot cake), health claims made by manufacturers, and changes in food labeling, including:

	Increase the type size for calories.
	Provide a percent Daily Value for calories.
	Eliminate "calories from fat" listing which takes the emphasis away from "total calories."

 

Overweight and obesity raise the risk for:
type 2 diabetes high blood pressure high cholesterol levels coronary heart disease congestive heart failure angina pectoris stroke asthma osteoarthritis musculoskeletal disorders gallbladder disease sleep apnea and respiratory problems gout bladder control problems	poor female reproductive health complications of pregnancy menstrual irregularities infertility irregular ovulation cancers of the uterus breast prostate kidney liver pancreas esophagus colon and rectum

At NIH, several Institutes are working on the obesity problem, including the National Heart Lung, and Blood Institute. Its Obesity Education Initiative, in cooperation with the National Institute of Diabetes and Digestive and Kidney Diseases, released in 1998 the first Federal guidelines on the identification, evaluation, and treatment of overweight and obesity in adults.⁶ These clinical practice guidelines are designed to help physicians in their identification and treatment of overweight and obesity, a growing public health problem. 

The guidelines present a new approach to the assessment of overweight and obesity and establish principles of safe and effective weight loss. According to the guidelines, the assessment of overweight involves three key measures—body mass index (BMI), waist circumference, and risk factors for diseases and conditions associated with obesity. The definitions in the guidelines are based on research that relates body mass index to the risk of death and illness, with overweight defined as a BMI of 25 to 29.9 and obesity as a BMI of 30 and above.

As BMI levels rise, the
average blood pressure and total cholesterol levels increase, and average high-density lipoprotein (HDL)
(good cholesterol) levels decrease. Females in the highest obesity category have four times the risk of either or both of these risk factors, compared to normal weight females. Therefore, the guidelines recommend weight loss to reduce high total cholesterol, raise low levels
of HDL, reduce high blood pressure, and reduce elevated blood glucose in overweight persons who have two or more risk factors and in obese persons. Overweight persons without other risk factors are advised to prevent further weight gain.