A Woman's Walk Through Obesity Management: Navigating Pathways of Care

By Samantha Schon, MD, MTR and Domenica Rubino, MD

Obesity is a chronic, progressive, multifactorial disease with serious health implications. The impact of obesity is profound, with recent estimates suggesting that > 40% of US adults have obesity (body mass index [BMI] ≥ 30 kg/m²), while ≈ 10% have severe obesity (BMI ≥ 40 kg/m²).¹ Women are disproportionately affected by obesity: data suggest that age-adjusted rates of obesity and severe obesity are higher among women than men² and that women have a greater risk for developing obesity-related conditions.³ Therefore, it is important to incorporate biological sex differences into obesity management, including for screening, diagnosis, documentation, and treatment.

Samantha Schon, MD, MTR

Domenica Rubino, MD

In an upcoming CME-accredited Special Issue Supplement to be published in Menopause, expert faculty will take a look at the lifetime impact of obesity at different stages of a woman's health journey and explore how obstetrics and gynecology (OB-GYN) healthcare professionals (HCPs) can help manage obesity to optimize women's health outcomes. Samantha Schon, MD, MTR, Assistant Professor in the Department of Obstetrics and Gynecology at the University of Michigan, Ann Arbor, MI, approaches the discussion from the perspective of an OB-GYN specialist, while Domenica Rubino, MD, founder and Director of the Washington Center for Weight Management & Research in Arlington, VA, brings her expertise as an obesity specialist.

How Does Obesity Impact Women's Health?

The presence of obesity has a profound and multisystemic impact on female physiology. Dr Schon and Dr Rubino will discuss the impact of obesity on different aspects of women's health at various stages of life, addressing questions such as:

What are the considerations for contraception and fertility in women with obesity?
How does obesity influence pregnancy and birth outcomes?
How does obesity impact the symptoms of menopause?
Are there special considerations for hormone therapy for women with obesity?

Discussing Obesity in the Clinic: What Is the Optimal Approach?

As the primary healthcare contact for many women in the United States, OB-GYN HCPs have a crucial role in optimizing healthcare outcomes for women with obesity.^4,5 However, evidence suggests that having obesity is associated with experiencing stigma, bias, and discrimination from HCPs, which can lead to healthcare avoidance.^6-9 Dr Schon and Dr Rubino will outline some of these issues, and discuss optimal approaches for caring for women with obesity, including:

How to raise the topic of obesity in a respectful way
Practical conversation starters for talking about obesity
Creating a supportive environment that is free from bias
Ensuring appropriate diagnosis of obesity and documentation in medical records

Treating Obesity to Optimize Women's Health Outcomes

There is an ever-expanding range of options to treat obesity and improve women's health outcomes in different times of life, including during the reproductive years and around the time of menopause. Dr Schon and Dr Rubino will summarize the available options and provide guidance on obesity management in different scenarios. Considerations will include:

What are the most appropriate treatment options for women with different comorbidities and concomitant medications?
How much weight loss is needed and what are the different methods to achieve meaningful weight loss?
What are the expected health benefits associated with effective management of obesity?
When are different obesity treatments contraindicated?

Put Your Knowledge Into Practice!

After reading the CME-accredited Special Issue Supplement, we invite you to put your knowledge into practice in our series of interactive videos! Each video will feature a different example of a woman living with obesity, and you will sit in the driver's seat to make choices on the most appropriate approaches to care, following each individual's journey.

Want to hear the latest on the upcoming CME-accredited Special Issue Supplement and interactive video series? Sign up here to be alerted when the supplement is published!

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