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Obesity & Ob-Gyn
작성자 관리자 작성일 2019-12-31 조회수 354

Obesity & Ob-Gyn

Ob-gyn should evaluate all women for obesity by calculating their Body Mass Index and offering appropriate interventions or referrals, according to a new Committee Opinion.

Committee Opinion #319, The Role of the Obstetrician-Gynecologist in the Assessment and Management of Obesity, addresses obesity in the nonpregnant adult woman. The document was published in the October issue of Obstetrics & Gynecology. (A Committee Opinion addressing obesity in pregnant women was published in the September issue of the Green Journal.)

With approximately one-third of all US women classified as obese – defined as a BMI of 30 or greater – obesity is the fastest growing health problem in the US. Obesity is associated with increased morbidity, including type 2 diabetes, hypertension, infertility, heart disease, gallbladder disease, osteoarthritis, and a variety of cancers, including breast, uterine, and colon cancers. In addition, obese women are five times more likely than nonobese women to develop endometrial cancer.

The Committee Opinion calls on ob-gyns to review a patient’s medical, social, and family history for weight-related conditions and calculate a patient’s BMI. If a patient’s BMI is greater, the severity of obesity (class I, II, or III) should be noted.

“Reinforcing the importance of weight loss and exercise and assessing the patient’s readiness to make behavioral changes should be the initial approach,” the document states. “The clinician should inform the patient in a sensitive manner that her weight is a health concern and assist her in developing a weight loss and exercise plan.”

If available, referral for further evaluation and treatment should be considered whenever the resources of the clinician are insufficient to meet the needs of patients with a BMI of 40 or greater or a BMI of 35 or greater with comorbidities and who have not been successful with appropriate prior interventions.

The document also addresses the use of the two most studied obesity drugs, orlistat marketed as Xenical, and sibutramine, marketed as Meridia.

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