Obesity in women of childbearing age: risks, prevention, and treatment.

This article reviews the health burden of obesity, its treatment and prevention, and potential barriers to care with special emphasis on adult women of childbearing age. From 1988 to 1994, 22% of nonpregnant women 18-49 years old in the United States were overweight (body mass index [BMI] >/= 25-29.9), and 22% were obese (BMI >/= 30). Both conditions increase the risk of chronic disease and mortality, and among women of childbearing age, overweight and obesity also increase the risk of infertility and adverse pregnancy outcomes.The three main strategies for preventing obesity are weight maintenance, weight loss for overweight and obese persons, and physical activity for all. More than 44% of nonpregnant women of childbearing age are trying to lose weight, and more than 33% are trying to maintain weight, but less than 21% of women of childbearing age use the recommended combination of physical activity and caloric restriction to try to lose or maintain weight. Pregnant women should try to gain no more than the recommended weight gain range for their prepregnancy BMI, yet about one third gain more weight.Although research has shown that advice from physicians can have an impact on their patients' eating habits and physical activity, many health professionals either provide no such advice or give inappropriate advice to women of childbearing age. Barriers may include inadequate reimbursement, time constraints, and lack of professional training. Frequent contact with women of childbearing age provides obstetricians and gynecologists and nurse specialists an opportunity to prevent and treat obesity successfully.