5 Key Things Women Should Know About Obesity

Many factors play a role in body weight, and biology is a big one. According to 2023 research, females may be more likely to have obesity, a condition relating to weight that increases the risk of heart disease, diabetes, and other chronic conditions. This is because factors like female hormones and body composition determine body fat distribution.

While it’s important to speak directly with your doctor about specific questions you may have about your weight, there are some general considerations if you have concerns about obesity.

On average, women’s bodies typically have a higher body fat composition than men’s. These differences usually start around puberty and link to hormones related to reproductive functions like pregnancy and menopause.

Estrogen, a hormone essential in female reproductive health, promotes body fat around the hips, thighs, and buttocks in menstruating individuals. This kind of fat is called gynoid fat and is important during pregnancy and nursing.

Research suggests that it has a lower rate of related health risks than visceral fat — fat stored in the abdomen that’s linked to more serious health issues, including heart disease and type 2 diabetes.

However, an excess of gynoid fat is known as gynoid obesity (excess accumulation of body fat in the lower part of the body), and studies suggest it may increase the risk of falls in women over 60. Moreover, when a person begins to experience menopause, estrogen levels drastically drop, which can lead to higher levels of visceral fat.

While some hormones promote healthy weight gain, some hormonal conditions like polycystic ovary syndrome (PCOS) — a condition that causes an increase in androgen hormones and insulin resistance — can lead to excessive weight gain, especially around the abdomen. Other hormone-related conditions, such as endometriosis, aren’t linked directly to obesity but can cause “endo belly” — fluid retention that appears similar to weight gain.

If you menstruate, weight gain might be a symptom that you experience monthly from your cycle. During the menstrual cycle, estrogen and progesterone can cause water retention and swelling in the abdomen, breasts, and other body parts. The hormonal fluctuation can also cause cravings for sugary and salty foods, which may lead to some minor weight changes.

A 2023 study suggests periods cause about a 1-pound average increase in weight, but this can be higher or lower depending on your body. This weight gain is usually temporary and not a cause for concern. However, if you’re noticing severe weight gain or swelling that doesn’t contract, consider talking with your doctor about changes during your menstrual cycle.

The body mass index (BMI) scale is one of the most common tools doctors and professionals use to categorize obesity. The scale takes the height and weight of an adult and uses a formula that can measure if a person has overweight or obesity.

A “healthy” BMI ranges between 18.5 and 24.9 for adults, but a higher BMI doesn’t necessarily mean you’re at an unhealthy weight. This is because BMI doesn’t consider a person’s muscle mass, and since muscle is denser than fat, a very muscular person can have a high BMI with low body fat.

BMI also doesn’t consider body composition, especially concerning gender and race. For example, an older study suggests that Black women often have less visceral tissue for a given waist circumference compared to white women, which may result in a lower risk for chronic illness than BMI or waist measurements alone suggest.

In contrast, women of Asian descent tend to store more visceral fat relative to their waist circumference, which increases their risk of conditions like type 2 diabetes and cardiovascular disease, even at lower BMIs.

This doesn’t mean you should disregard the BMI scale, though. It’s still a widely used tool to give a general measurement of health risks. If you’re concerned about your BMI number or risk for obesity, talk with your doctor.

Many women have unique factors that can affect weight, including pregnancy, caregiving, and other responsibilities that may leave little room for exercise or planning nutrient-dense meals. Society can also place additional pressure to fit a certain body image or unrealistic beauty standards. All these factors may lead to stress or a lack of sleep and disrupt the stress hormone cortisol, which can eventually lead to weight gain.

If you’re experiencing these stressors or similar ones, reach out to your primary care doctor and consider speaking with a mental health professional. You may feel slightly reluctant to prioritize your needs if you have a busy life, but it’s extremely important to take control of your health to ensure that you can continue safely managing your day-to-day responsibilities.

Obesity is more than a number on a scale — it’s linked to a range of health concerns, including:

• Heart disease: People who have obesity may have a higher risk of experiencing a heart attack, high blood pressure, and stroke.
• Type 2 diabetes: Excess body fat can make the body less sensitive to insulin, leading to diabetes.
• Reproductive issues: Obesity is associated with irregular periods, infertility, and pregnancy complications.
• Cancer: Women who have obesity may have a higher likelihood of developing breast, ovarian, and endometrial cancers.

While women have unique challenges when it comes to obesity, there are strategies to help manage weight and improve overall health. Small changes can make a big difference over time, including:

• prioritizing sleep
• finding stress relief tactics
• staying active

If you have questions about your weight or related health concerns, talk with a healthcare professional to develop a plan that fits your needs and lifestyle.

Biological, hormonal, and societal factors influence weight and body fat in women, and many of those factors can directly lead to obesity.

Women also naturally carry more body fat than men due to estrogen and experience shifts in fat distribution during life stages like menopause. Because of this, it’s important to stay connected with your doctor to make sure you’re sticking to a healthy plan to help manage a weight that’s right for you.