Obesity and women

Clearinghouse Connector – July 2016


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Introduction

Over half of Australian adult women (56.3%) are overweight or obese, compared with 70.8% of men.1 Although a higher percentage of men are above a healthy weight, the obesity rate in women is equal to that of men (27.5% in 2011-12).2 In younger and mid-age Australian women, there is an overall trend of continuing weight gain and increasing levels of overweight and obesity.3

Overweight and obesity prevalence are associated with a wide range of factors including: economic status, age, cultural background, education level, rurality, fresh food supply and availability of green space,3 however weight patterns for these factors differ by gender.3 Socioeconomic disadvantage correlates directly with increased overweight or obesity in women, but not in men.1 Women aged 45 to 54 have the highest obesity rate among Victorian women.4 Aboriginal and Torres Strait Islander women are 1.7 times more likely to be obese than non-indigenous women.2

Obesity is the primary cause of chronic illness in Australian women,3 and can impact on health at each stage of a woman’s life cycle.5,6 Being overweight or obese increases the risk of heart disease, diabetes,6 and 11 types of cancer including breast, ovarian and endometrial cancer.7 Obesity in reproductive-aged women negatively impacts on contraception and fertility, and increases the risk of pregnancy complications (particularly gestational diabetes and hypertension) and poorer infant outcomes.6,8 Overweight and obese women and girls face stigma, workplace discrimination, and suffer far more than overweight men and boys from eating disorders and body image issues.9 Obesity is also a barrier to women discussing weight and associated health issues with health providers.10,11

At a population level, strategies to address obesity are now focusing less on individual behaviour change and ideas of self-control, and more on better understanding and modifying the obesity-promoting (obesogenic) environment.12,13 The primary prevention of obesity may prove more effective and enduring than secondary prevention (treatment after weight gain has occurred).14 The success rate of weight loss interventions does not differ greatly between women and men.15 Both obesity prevention initiatives and weight loss interventions may be more effective if framed and delivered in a gender-specific manner.16

There is growing evidence to suggest that health promotion strategies and public health messaging should consider obesity and eating disorders as part of the same continuum, with common risk/protective factors, and common goals (optimal health, nutrition, food habits, and body image).17 Further research is needed to better understand gendered weight patterns,18 and the obesity prevention strategies and interventions that are most effective for women. This will provide evidence to inform multi-level action to address overweight and obesity in Australian women.


Much of the literature about women and obesity is contained within general, rather than women-specific resources – as reflected in the selection of materials for this Connector.

WHV thanks the following expert reviewers for their input:


Overview

No time to weight : obesity, a national epidemic and its impact on Australia Obesity Australia, 2014

We can avoid weight creep : here’s how The Conversation, 2016

Fat city : what can stop obesity? The Saturday Paper. The Monthly Essay, 2013


Prevalence and trends

Overweight and obesity In: 4364.0.55.001 – National Health Survey: First Results, 2014-15 Australian Bureau of Statistics, 2015

Australian heart disease statistics : overweight, obesity and cardiovascular disease : past, present and future National Heart Foundation of Australia, 2015

Weight gain, overweight and obesity: determinants and health outcomes from the Australian Longitudinal Study on Women’s Health Current Obesity Reports, 2014

Morbid obesity in women on the rise: an observational, population-based study BMC Public Health, 2013 – Australian study


General women’s health

Obesity and women’s health : an evidence-based review Journal of American Board of Family Medicine, 2012

Half a million new cancers in 2012 due to overweight and obesity : proportion of obesity-related cancers higher in women World Health Organization. International Agency for Research on Cancer, 2014


Sexual and reproductive health

Obesity and reproduction : a fact file Your Fertility (Fertility Coalition), 2015

Interventions to reduce and prevent obesity in pre-conceptual and pregnant women : a systematic review and meta-analysis PLoS One, 2014

Overweight and obesity in Australian mothers: epidemic or endemic? Medical Journal of Australia, 2012

Development of the Blooming Together Program – a comprehensive model of maternity care incorporating evidence based behavioural change strategies for women with obesity to achieve a healthy pregnancy weight : final research report Telethon Institute for Child Health Research (Perth), 2013

The role of bariatric surgery in improving reproductive health : scientific impact paper Royal College of Obstetricians and Gynaecologists (UK), 2015

Sexuality and obesity, a gender perspective: results from French national random probability survey of sexual behaviours BMJ, 2010


Biological factors

Obesity and hormones Victoria. Department of Health, 2016 – (Better Health Channel Factsheet)

The estrogen hypothesis of obesity PLoS One, 2014

Weight gain at the time of menopause World Obesity Federation Blog, 2015

Sex-specific weight loss drugs : men’s and women’s brains may react differently to obesity medications Medical Daily, 2016


Mental health and body image

Promoting self-esteem in overweight and obese girls NPWomen’s Healthcare, 2014

Technical report : from weight to well-being : time for a shift in paradigms? : a discussion paper on the inter-relationships among obesity, overweight, weight bias and mental well-being British Columbia. Provincial Health Services Authority, 2013

Weight bias : does it affect men and women differently? Obesity Action Coalition (Florida), 2013

Studies of obesity, body image and related health issues among Australian adolescents: how can programs in schools interact with and complement each other? Journal of Student Wellbeing, 2010


Relationship between gender and other social determinants

Weight influences where women choose to live, researchers claim The Age. Domain, 2016

Obese women face discrimination in job hunt The Conversation, 2012

The food insecurity-obesity paradox as a vicious cycle for women : a qualitative study Atlantic Centre of Excellence for Women’s Health, 2012

Explaining the gender gap : obesity costs women a lot more than men Time, 2010


Lifestyle modification

Effectiveness of weight loss interventions : is there a difference between men and women : a systematic review Obesity Reviews, 2015

Preventing weight gain in women in rural communities : a cluster randomised controlled trial [Australia] PLoS Medicine, 2016

Behavior and weight correlates of weight-control efforts in Australian women living in disadvantage : The READI study International Journal of Behavioral Nutrition and Physical Activity, 2013

Middle-aged women’s decisions about body weight management : needs assessment and testing of a knowledge translation tool Menopause, 2015 and Patient decision aid used in the study

Experiences of barriers and facilitators to weight-loss in a diet intervention – a qualitative study of women in Northern Sweden BMC Women’s Health, 2014

Goal setting for health behavior change: evidence from an obesity intervention for rural low-income women Rural and Remote Health , 2014


Gender-responsive obesity interventions

Gender norms and obesity : incorporating gender norms change into clinical interventions Obesity, 2016

Evidence for gender responsive actions to prevent and manage overweight and obesity : young people’s health as a whole-of-society response World Health Organization Europe, 2011


Australian clinical practice guidelines

A synthesis of selected national Australian guidelines on the general practice management of adult patients who are overweight or obese Australian Family Physician, 2016

Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia Australia. National Health and Medical Research Council, 2013

Management of obesity in pregnancy RANZCOG College Statement, 2013


Australian policy development

Obesity In: National women’s health policy Australia. Department of Health, 2011

Weighing the cost of obesity : a case for action : a study on the additional costs of obesity and benefits of intervention in Australia PricewaterhouseCoopers, October 2015

Policy at a glance : promoting healthy weight policy Public Health Association of Australia, 2013

Australia the healthiest country by 2020 : technical report 1 : obesity in Australia : a need for urgent action Australia. National Preventative Health Taskforce. Obesity Working Group, 2009


Victorian policy development

Victoria’s Citizens' Jury on Obesity VicHealth, 2016. – See Appendix 2 (Steering Group’s Response to 20 recommended actions)

Healthy Together Victoria : about us [Campaign] Victoria. Department of Health and Human Services, 2016

Victorian public health and wellbeing plan 2015-2019 Victoria. Department of Health, 2015 – See p. 17 ‘Risk factors’

Fat chance [Video] ABC Online. Four Corners, 2014 – Community-level intervention in Ararat, Victoria


Related websites

Victoria. Department of Health and Human Services Healthy Together Victoria [Program]

VicHealth Promoting Healthy Eating [Program]

Cancer Council Victoria Obesity prevention initiatives

Obesity Policy Coalition

Obesity Australia

Australia. Department of Health Healthy weight guide

Australia. National Health and Medical Research Council Obesity and overweight


Footnotes

  1. ABS (2015). Overweight and obesity In: 4364.0.55.001 - National Health Survey: First Results, 2014-15. Australian Bureau of Statistics. Accessed on 01/07/2016.
  2. Nichols M, Peterson K, Herbert J, et al. (2015). Australian heart disease statistics : overweight, obesity and cardiovascular disease – past, present and future. National Heart Foundation of Australia. Accessed on 01/07/2016.
  3. Gomersall SR, Dobson AJ, Brown, WJ (2014). Weight gain, overweight and obesity: determinants and health outcomes from the Australian Longitudinal Study on Women’s Health. Current Obesity Reports. 2014(3) : 46-53. Accessed on 01/07/2016.
  4. Victoria. Department of Health and Human Services (2016). Victoria population health survey 2013 : selected indicators and trends. Victoria. DHHS. p. 34. Accessed on 01/07/2016.
  5. Kanter R, Caballero B. (2012). Global gender disparities in obesity : a review. Advances in Nutrition. 3(4) : 491-498. Accessed on 01/07/2016.
  6. Kulie T, Slattengren A, Redmer J, et al. (2012). Obesity and women's health : an evidence-based review. Journal of American Board of Family Medicine, 24(1) : 75-85. Accessed on 01/07/2016.
  7. World Cancer Research Fund International (2016). Cancer prevention and survival : summary of global evidence on diet, weight and physical activity, and what increases or decreases your chance of cancer. WCRF. London. p. 5. Accessed on 01/07/2016.
  8. Records K (2016). Obesity and women's health. JOGNN, 44(6) : 758-759.
  9. King K, Puhl R (2013). Weight bias : does it affect men and women differently?. Obesity Action Coalition (Florida). Accessed on 01/07/2016.
  10. Goldkamp J, Gavard JA, Lifits-Podorozhansky Y. et al. (2016). Women’s perceptions regarding obesity and comorbidities and provider interaction. JOGNN. 44(6):784-92.
  11. Shelley A (2015). Women's heart health hindered by social stigma about weight. Medscape Multispecialty, Apr 3. Accessed on 01/07/2016.
  12. Australia. National Preventative Health Taskforce. Obesity Working Group (2009). Australia : the healthiest country by 2020 : technical report 1 : obesity in Australia : a need for urgent action. Australia. National Preventative Health Taskforce, p.15. Accessed on 01/07/2016.
  13. Australia. National Health and Medical Research Council (2015). Obesity and overweight. Circulation. 133(2): 187. Accessed on 01/07/2016.
  14. (2016). Dietary and policy priorities for cardiovascular disease, diabetes, and obesity : a comprehensive review. NHMRC. Accessed on 01/07/2016.
  15. Williams, RL; Wood, LG; Collins, CE; et al (2015). Effectiveness of weight loss interventions : is there a difference between men and women : a systematic review. Obesity Reviews, 2015: 16 : 171-186. Accessed on 01/07/2016.
  16. Kanter R, Caballero B. (2012). Global gender disparities in obesity : a review. Advances in Nutrition. 3(4) : 491-498. Accessed on 01/07/2016.
  17. National Eating Disorders Collaboration (2015). Communicating about eating disorders and obesity. NEDC. Accessed on 01/07/2016.
  18. The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders; University of Sydney. Menzies Centre for Health Policy (2014). Weight and gender. In. Obesity prevalence trends in Australia : evidence brief. Australian National Preventive Health Agency. p. 6. Accessed on 01/07/2016.

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