Steps Ob/Gyns Can Take to Fight Obesity

Larry Hand

February 20, 2014

The American College of Obstetricians and Gynecologists (ACOG) Committee on Health Care for Underserved Women has released recommendations on what obstetricians and gynecologists can do to initiate dialogs with patients and to address the epidemic of overweight and obesity in the United States.

According to the National Center for Health Statistics, in the United States, 69% of adults are either overweight or obese, and 35% of adults are obese.

The ACOG committee recommendations revolve around the concept of a "built environment," the physical and social characteristics of a community, combined with lifestyle behaviors that go along with obesity, "particularly among adult women," according to the committee opinion, published online February 19 and in the March issue of Obstetrics & Gynecology.

Among the factors associated with obesity in some urban environments are limited access to safe areas for exercise and lack of large grocery stores offering economically priced healthy foods. Research has shown that inner-city women have a particularly high risk for obesity.

Rural areas may have limited or no sidewalks or unlit recreation areas.

In addition, according to the Centers for Disease Control and Prevention, obesity prevalence varies by US geographic region, with the highest prevalence in the South (30%), followed by the Midwest (29%), Northeast (25%), and West (24%). No state or region met the Healthy People 2010 target to reduce obesity rates to 15%.

The committee writes that although physicians may find it difficult to find time during an office visit to discuss healthy diets and potential lifestyle changes, motivational interviewing might help improve communication and promote positive behavioral changes. They refer to a previous opinion on techniques of motivational interviewing.

12 Recommended Actions

Specifically, the committee offers 12 recommendations:

  • "Discuss healthy lifestyle behavior at each visit. Multiple discussions can facilitate an open dialogue and opportunities to develop weight loss strategies."

  • "Encourage discussions of physical activity and the range of food choices available in local neighborhoods during prenatal and postpartum visits."

  • "Use motivational interviewing techniques to assist women in developing a long-term commitment to weight loss and healthy living."

  • "Advocate for the sponsorship of a free exercise or wellness program at your hospital or medical organization."

  • "Partner with your hospital's community liaison office to advocate for further construction of safe, accessible outdoor recreational areas."

  • "Volunteer to represent your hospital at community initiatives to increase supermarkets or improve recreational venues in the city."

  • "Encourage patients to consider shopping at farmers' markets, if few large grocery stores with ample, reasonably priced vegetables are available to them."

  • "Support city and state health department efforts to expand data collection and improve surveillance of trends in obesity and other chronic conditions."

  • "Encourage your hospital administration to partner with nutritionists, social workers, and community-based fitness clubs (eg YMCA) to provide a multifaceted approach to lifestyle behavioral change."

  • "Collaborate with other clinicians to encourage local grocery store owners to expand the selection of fruits and vegetables and encourage the development of farmers' markets."

  • "Display handouts, when possible, in examination rooms or the reception area with recommendations for daily calorie intake and physical activity."

  • "Provide materials on preparation of low-calorie meals (available for free) from the National Institute of Diabetes and Digestive and Kidney Diseases at www.win.niddk.nih.gov/publications/index.htm."

"Challenges for Overweight and Obese Women." American College of Obstetricians and Gynecologists Committee on Health Care for Underserved Women. Full text

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