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Counseling is effective in preventing obesity for middle-aged women

OHSU researchers recommend focusing discussions on healthy eating and physical activity to maintain weight or limit weight gain
A doctor talking with a woman .
Counselng is an effective method in obesity prevention for middle-age women, OHSU researchers contend. (Getty Images)

Counseling women ages 40 to 60 years may be effective for maintaining or limiting weight gain, Oregon Health & Science University researchers found.

The study, published this month in Annals of Internal Medicine, aims to address the common condition of obesity in midlife women and informs a new clinical guideline for prevention strategies.

Amy Cantor, M.D., M.P.H., stands on a balcony at OHSU with Doernbecher Children's Hospital in the background.
Amy Cantor, M.D., M.P.H. (OHSU)

“Obesity affects many women during midlife, so it’s important that we normalize conversations around weight gain and reduce the stigma surrounding obesity,” said Amy Cantor, M.D., M.P.H, associate professor of medical informatics and clinical epidemiology, family medicine and obstetrics and gynecology in the OHSU School of Medicine. “The recommendation coming out of this study is encouraging and provides clinicians with actionable insights that can improve women’s health, well-being and overall quality of life.”

Obesity is a common condition for women during midlife, affecting 43% of American women age 40 to 59. Women may struggle with weight gain due to physiologic changes related to aging, menopause, reduced physical activity and changes in body composition. Because obesity increases the risk for many chronic conditions, including hypertension, or high blood pressure; dyslipidemia, or elevated cholesterol; type 2 diabetes; coronary artery disease, or heart disease; and stroke, identifying strategies for prevention is crucial.

There are existing recommendations that address diet and exercise counseling for adults with obesity, but recommendations have not addressed prevention specifically for midlife women. Researchers in this study aimed to fill that gap.

Cantor’s team led the research to inform the recommendation from the Women's Preventive Services Initiative (WPSI), a national coalition of women's health professional organizations and patient advocacy representatives. They conducted a systematic review that included seven randomized control trials with 51,638 participants. The majority of trials that were evaluated focused on counseling participants, with clinicians offering advice or specific recommendations on behavior change, such as weight monitoring, dietary changes or physical activity.

Researchers found that using these methods led to positive weight changes among study participants. As a result, they recommend counseling midlife women, age 40 to 60, who have normal or high body mass index, or BMI, in order to help maintain weight or limit weight gain and prevent obesity. Counseling interventions may include personalized discussion of healthy eating and physical activity, as well as sensitivity to concerns about the stigma surrounding weight and obesity.

Although the recommendations provide valuable and actionable insights for clinicians, Cantor said more research needs to be done to identify specific behavioral interventions that are effective, feasible and sustainable, and can be implemented in primary care settings among diverse populations. Efforts should focus on improving training of clinicians and educators, assessing the role of technology and evaluating long-term health outcomes. There is also a need to understand the effects of social determinants of health and tailor interventions to specific populations, especially vulnerable groups and those who face barriers to accessing care.

This project was supported by the American College of Obstetricians and Gynecologists and Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UHOMC29440, Bright Futures for Women’s Health: Standard Practice Guidelines for Well Women Care. This information or content and conclusions are those of the author and should not be construed as the official position nor policy of, nor should any endorsements be inferred by HRSA, HHS, or the U.S. Government.

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