Obesity is one of the most complex and largely preventable diseases that affects around one-third of the world’s population. If left unattended, it is estimated that around 38% of the young population in the world will be overweight and around 20% will be obese by 2030. Obesity affects all age groups and can increase the risk of other diseases. Moreover, it can have an adverse impact on psychological health.
In women, obesity around the abdomen (abdominal obesity or central obesity) may be associated with polycystic ovarian syndrome (PCOS). Moreover, it also impacts one’s sexual drive and performance. Here are some of the common health complications due to obesity in women.
1. Diabetes: Studies have reported a strong association between obesity and type 2 diabetes in both genders. As compared to women with a healthy weight, overweight women are three times more likely to develop diabetes, while the risk is seven times higher in obese women. Being obese also increases the risk of gestational diabetes in pregnant women.
Diabetes in obese women is attributed to insulin resistance, which means the body has to produce more insulin. This overtime forces the pancreas to produce more insulin, which slowly becomes exhausted and cuts down the insulin production. This causes excess accumulation of glucose leading to diabetes.
2. Coronary artery disease: Being overweight or obese means accumulation of excess fat. Studies have shown that obesity is associated with the reduced high density of lipoprotein (HDL, also called as ‘good cholesterol’) and increased triglycerides, which contribute to high levels of lipids in the blood. Moreover, there is a marked increase in blood pressure levels with weight gain. This further increases the risk of coronary heart disease. Studies have also reported an increased risk of heart failure and ischemic stroke in women who are obese.
A cohort study of more than 44,000 women found an association between waist circumference and risk of cardiovascular disease. Women with a waist circumference of more than 88 cm had three times higher risk of death due to cardiovascular disease. Hence, abdominal obesity is far more harmful in women than body mass index or overall weight.
3. Respiratory disorders: Several studies have pointed to a link between pulmonary problems such as obstructive sleep apnea (OSA) and asthma with obesity. OSA could be due to increased fat tissue along the airway, which affects the functioning of the airways. Asthma is considered to be a common complication of obesity that increases the airway responses due to obesity-related inflammation.
4. Infertility: Women who are obese are at a higher risk of suffering from PCOS, which is one of the primary causes of infertility. PCOS is characterized by hyperandrogenemia (excess levels of androgens, male hormones, in females), which can lead to infertility. It also causes menstrual abnormalities and anovulation, which reduces the chances of conception. According to a 2008 study published in the Journal Fertility and Sterility, around 30% to 47% of overweight and obese women have irregular menses.
Moreover, it can lead to poor outcome after fertility treatment and can also up the risk of pregnancy loss or miscarriage. The risk of miscarriage was found to be 38.1% in obese women and 13.3% in women with a normal BMI. It has been suggested that obesity induces endometrial damage, which in turn affects the implantation process and thus prevents a woman from conceiving.
5. Sexual dysfunction: Female sexual dysfunction or psychophysiological disturbances associated with sexual desire, arousal, orgasm, and pain disorders affects approximately 40% of the female population. Obesity is linked to the impaired quality of life and one important aspect of quality of life is sexual functioning.
Obesity can affect the psychological well being of a woman, which can, in turn, impact her sex life.It can lead to difficulties in attaining orgasm, lowers the sex drive and decreases the frequency of sexual intercourse. It also affects sexual satisfaction, which impacts the overall sex life in women (as well as in men).
6. Pregnancy-related complications: Maternal obesity during pregnancy can impact both mother and baby. It not only increases the risk of spontaneous abortion but also puts the mother at a high risk of gestational diabetes and hypertension. Being obese not only prolongs the pregnancy but also causes difficulty during delivery due to increased risk of infections. Kids born to obese mothers have a considerable risk of suffering from childhood obesity and metabolic disorders later in life.
7. Cancer: There are numerous research studies that have suggested obesity as a key risk factor for various types of cancer in women, such as endometrial, ovarian, cervical and breast cancer. This could be due to hormonal imbalances in obese women. For example, high levels of estrogen synthesized from the fat tissue in obese women increase the risk of several types of cancer, such as uterus and breast cancer.
Chronic exposure to the hormone estrogen can lead to the proliferation of endometrial cells, which in turn raises the risk of endometrial cancer. Studies have suggested that being obese is associated with a 2 to 3 fold increased risk of endometrial cancer. Moreover, obesity was found to be associated with at least a 40% increased incidence of endometrial cancer in premenopausal and postmenopausal women.
Several studies have shown an increased incidence as well as higher mortality from cervical cancer among obese women. There is also a well-established link between obesity and breast cancer in women post-menopause, which is attributed to an increase in the concentration of estrogen in the blood. Moreover, obese women who suffer from cancer have lower chances of survival due to late screening, comorbid conditions and poor response to treatment.
Bottom line: The health complications caused due to obesity can be prevented if you keep your weight under control. Eating right, staying active and exercising regularly hold the key to maintaining a healthy body weight for better health and fitness.
(The article is reviewed by Dr. Lalit Kanodia, General Physician)
Kulie T, Slattengren A, Redmer J, Counts H, Eglash A, Schrager S. Obesity and women’s health: an evidence-based review. J Am Board Fam Med. 2011 Jan-Feb;24(1):75-85.
Hruby A, Hu FB. The Epidemiology of Obesity: A Big Picture. Pharmacoeconomics. 2015 Jul;33(7):673-89.
Templeton A. Obesity and Women’s Health. Facts Views Vis Obgyn. 2014;6(4):175-6.
Dağ ZÖ, Dilbaz B. Impact of obesity on infertility in women. J Turk Ger Gynecol Assoc. 2015 Jun 1;16(2):111-7.
Nho JH. Lifestyle Intervention for Obese Women. J Lifestyle Med. 2017 Jul;7(2):51-54.
Segula D. Complications of obesity in adults: a short review of the literature. Malawi Med J. 2014 Mar;26(1):20-4.