Age

• As shown in Table 2, women are more likely to become overweight (BMI of 25 or more) as they become older.

  Table 2
  
  

  Increase in Overweight Prevalence with Age Among U.S. Women (1999 to 2000)
  Age (Years)	Prevalence (%)
  20 to 39	54.3
  40 to 59	66.1
  60 and older	68.1
  Source: CDC, National Center for Health Statistics, National Health and Nutrition Examination Survey. Flegal et. al. JAMA. 2002;288:1723-7.

  
  
• Obesity (BMI of 30 or more) has increased among U.S. women of all age groups over the last decade, as shown in Table 3.

  Table 3
  
  

  Increase in Obesity Prevalence (%) Among Women by Age Group
  Age (Years)	1988 to 1994	1999 to 2000
  20 to 29	14.6	23.3
  30 to 39	25.8	32.5
  40 to 49	26.9	35.4
  50 to 59	35.6	41.2
  60 to 69	29.8	42.5
  70 to 79	25	31.9
  80 and older	15.1	19.5
  Source: CDC, National Center for Health Statistics, National Health and Nutrition Examination Survey. Flegal et. al. JAMA. 2002;288:1723-7.

• Middle-age women are at a particularly high risk of becoming obese. The prevalence of obesity among middle-age women (ages 35 to 64) has increased at a minimum of 2 percentage points per year over a 40-year time period from 1960 to 2000. Table 4 indicates prevalence changes in obesity (BMI of 30 or more) between 1960 and 2000 for U.S. women in various middle-age groups.

  Table 4
  
  

  Increase in Obesity Prevalence (%) Among Middle-Age Women Over a 40-Year Time Period
  Age (Years)	1960 to 1962	1999 to 2000	Percentage Point Change
  35 to 44	14.7	33.9	19.2
  45 to 54	20.3	38.1	17.8
  55 to 64	24.4	43.1	18.7
  Source: CDC, National Center for Health Statistics, National Health and Nutrition Examination Survey. Health, United States (Table 70) 2002.

Race

• Among U.S. adults, black (non-Hispanic) women have the highest prevalence of overweight (78 percent) and obesity (50.8 percent).
• Table 5 shows the discrepancy in overweight and obesity prevalence among U.S. women (ages 20 to 74) by racial / ethnic group.

  Table 5
  
  

  Increase in Overweight and Obesity Prevalence (%) Among Women by Racial / Ethnic Group
  Racial / Ethnic Group	Overweight (BMI > 25)	Obesity (BMI > 30)
  Black (non-Hispanic)	78	50.8
  Mexican American	71.8	40.1
  White (non-Hispanic)	57.5	30.6
  Source: CDC, National Center for Health Statistics, National Health and Nutrition Examination Survey. Health, United States (Table 70) 2002.

• A direct association has been found between body weight and deaths from all-causes in women, ages 30 to 55.

• When BMI exceeds 30, the relative risk of death related to obesity increases by 50 percent.

• There are many obesity-related conditions, which uniquely or mostly affect women, including those detailed below.

• Women with obesity have almost four times the risk of osteoarthritis as non-obese women.

• A stronger association between osteoarthritis and obesity has been observed in women than in men.

• Maternal obesity (BMI > 29) has been associated with an increased incidence of neural tube defects (NTD) in several studies, although variable results have been found in this area.
• Folate intake, which decreases the risk of NTD’s, was found in one study to have a reduced effect with higher pre-pregnancy weight.

• After menopause, women with obesity have a higher risk of developing breast cancer. In addition, weight gain after menopause may also increase breast cancer risk.

• Women who gain about 45 pounds or more after age 18 are twice as likely to develop breast cancer after menopause than women with no weight gain.
• Before menopause, high BMI has been associated with a decreased risk of breast cancer. However, a recent study found an increased risk of the most lethal form of breast cancer, called inflammatory breast cancer (IBC), in women with BMI as low as 26.7 regardless of menopausal status.
• Before menopause, women who are overweight and have breast cancer appear to have a shorter life span than women with lower BMI.

• Women with obesity have three to four times the risk of EC than women with lower BMI.
• An estimated 34 to 56 percent of EC risk can be attributed to overweight.
• Body size is a risk factor for EC regardless of where fat is distributed in the body. Women with obesity and diabetes have a 3-fold increase in risk for EC above the risk of obesity alone.

• In middle and older age groups, heavier weight is associated with CVD and its risk factors, particularly for women.

• Obesity is the best-established predictor of gallbladder disease in women.
• Women with obesity have at least twice the risk of gallstone disease than women of normal weight.

• Obesity has been found to affect ovulation, response to fertility treatment, pregnancy rates and pregnancy outcome.
• Infertile women with obesity who lose weight have shown improvement in becoming pregnant and reaching full term.

• In addition to infertility, excess body fat can lead to complications such as menstrual abnormality, miscarriage and difficulties in performing assisted reproduction.
• The frequency of menstrual disturbance in women with severe obesity is three times greater than for women of normal weight.
• High pre-pregnancy weight is associated with an increased risk of pregnancy hypertension, gestational diabetes, urinary infection, Cesarean section delivery and toxemia.
• Women with obesity are 13 times more likely to have overdue births, longer labors, induced labor and blood loss.
• Complications after childbirth, related to obesity, include an increased risk of wound and endometrial infection, endometritis and urinary tract infection.

• Obesity is a well-documented risk factor for the involuntary loss of urine as well as urgency.
• Obesity has been found to be a strong risk factor for women of several urinary symptoms after childbirth.

• Women with obesity appear to have much more prejudice and discrimination directed against them than men with obesity.
• Obesity contributes to unemployment for women. After undergoing surgery to reduce obesity, a drop in unemployment rate from 84 to 64 percent was reported for women.
• Women with obesity face significant barriers in establishing and maintaining social relationships in a society that emphasizes thinness as physical attractiveness.
• Women with obesity have reported attending fewer years of college and receiving less financial support for higher education than women who are non-obese.

Note: Readers should note that researchers have not always used the same criteria to identify overweight and obesity. In this fact sheet, AOA has attempted to use the generally accepted definitions for overweight as a Body Mass Index (BMI) of 25 to 29.9 and obesity as a BMI of 30 or more. We have made an effort to identify studies which have used these specific definitions as well as other scientifically accepted measurements such as waist circumference and waist to hip ratio.