Obesity - Women in Illinois

Illinois

Obesity is a complex health condition with biological, economic, environmental, individual and societal causes. Known contributing factors to obesity include social and physical environment, genetics, prenatal and early life influences and behaviors such as poor diet and physical inactivity.

Adults with obesity are at an increased risk of developing serious health conditions, including hypertension, Type 2 diabetes, heart disease and stroke, sleep apnea and breathing problems, some cancers and mental illnesses like depression and anxiety. 

Obesity can impact reproductive health in women and is negatively associated with fertility, contraception effectiveness and mother and infant health during the perinatal period. This includes increased risk of gestational hypertension, gestational diabetes and birth complications such as preeclampsia, cesarean section and postpartum hemorrhage, as well as miscarriage, stillbirth, neonatal mortality and infant mortality.

A recent study estimated the annual medical cost of obesity in the United States to be nearly $173 billion (in 2019 dollars). 

While body mass index (BMI) can serve as an easily accessible proxy for population health, it has its limitations. BMI does not distinguish between excess fat and muscle or bone mass, and the relationship between BMI and body fat is influenced by sex, age and ethnicity. Further, it does not capture the complexity of human health; individuals can have a high BMI and good cardiovascular health, while others can have what is categorized as a “healthy” or “normal” BMI and poor cardiovascular health. The American Medical Association adopted a new policy in 2023 addressing the shortcomings of BMI as a clinical measure of health and suggesting that BMI be used in conjunction with other valid measures, such as body composition. 

Additionally, weight stigma, also known as weight-based discrimination or weight bias, can have many negative impacts, including mood and anxiety disorders and avoidance of exercise. Weight stigma is pervasive in health care, with reports of medical professionals spending less time with higher-weight patients, engaging in less education and even being reluctant to perform certain procedures on patients with a higher BMI. Weight stigma in the clinical environment can make individuals feel uncomfortable or marginalized, resulting in avoidance of seeking health care.

According to America’s Health Rankings data, the prevalence of obesity is higher among:

• Women ages 35-44 compared with women ages 18-24 and 25-34; the prevalence of obesity is higher with each increase in age group. Women ages 18-24 have the lowest prevalence.
• Black and Hawaiian/Pacific Islander women compared with white and Asian women; Asian women have the lowest prevalence. 
• Women with some post-high school education or less compared with college graduates, who have the lowest prevalence of obesity.
• Women with an annual household income less than $25,000 compared with women with higher income levels; the prevalence of obesity is higher with each decrease in income level.
• Women living in non-metropolitan areas compared with those in metropolitan areas.

Addressing obesity requires a multifaceted approach involving policymakers, state and local governments, health care and child care professionals, schools, families and individuals. The Centers for Disease Control and Prevention (CDC) offers prevention strategies at the state, local and community levels as well as tips for living a healthy lifestyle. 

The Community Preventive Services Task Force has compiled a list of resources for the prevention and management of obesity. The Healthy Weight Checklist provides information on and measurable targets for eating healthy, getting enough sleep and physical activity, limiting screen time and reducing stress, all of which influence weight gain and management. County Health Rankings & Roadmaps lists several strategies for increasing physical activity and reducing obesity rates, including neighborhood environment enhancements to create more access to physical activity and multi-component obesity prevention interventions that coordinate treatments and planning across different areas. 

The CDC recommends weight gain tracking to promote healthy pregnancy weight.

Healthy People 2030 has several objectives related to weight and obesity, including: 

• Reducing the proportion of adults with obesity.
• Increasing the proportion of women who had a healthy weight before pregnancy.

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Ely, Danielle M., Elizabeth C. W. Gregory, and Patrick Drake. “Infant Mortality by Maternal Prepregnancy Body Mass Index: United States, 2017-2018.” National Vital Statistics Reports: From the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System 69, no. 9 (August 2020): 1–11. https://pubmed.ncbi.nlm.nih.gov/33054916/. 

Gutin, Iliya. “In BMI We Trust: Reframing the Body Mass Index as a Measure of Health.” Social Theory & Health 16, no. 3 (August 2018): 256–71. https://doi.org/10.1057/s41285-017-0055-0.

Kulie, Teresa, Andrew Slattengren, Jackie Redmer, Helen Counts, Anne Eglash, and Sarina Schrager. “Obesity and Women’s Health: An Evidence-Based Review.” Journal of American Board of Family Medicine 24, no. 1 (February 2011): 75–85. https://doi.org/10.3122/jabfm.2011.01.100076.

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Tomiyama, A. Janet, Deborah Carr, Ellen M. Granberg, Brenda Major, Eric Robinson, Angelina R. Sutin, and Alexandra Brewis. “How and Why Weight Stigma Drives the Obesity ‘Epidemic’ and Harms Health.” BMC Medicine 16, no. 1 (December 2018): 123. https://doi.org/10.1186/s12916-018-1116-5.

Ward, Zachary J., Sara N. Bleich, Michael W. Long, and Steven L. Gortmaker. “Association of Body Mass Index with Health Care Expenditures in the United States by Age and Sex.” Edited by Robert Siegel. PLOS ONE 16, no. 3 (March 24, 2021): e0247307. https://doi.org/10.1371/journal.pone.0247307.