Why are more women losing the battle of the bulge?
Cultural pressures affect the equation
MINNEAPOLIS — Frances Traphagan has been battling weight issues her whole life.
For years, the south Minneapolis mom struggled to balance work and motherhood. After every pregnancy, her weight problem grew. Her habit of eating on the run also tipped the scales in the wrong direction.
Finally, at 240 pounds, the 5-foot-3 Traphagan chose to have bariatric surgery at the Hennepin Bariatric Center and Obesity Program at Hennepin County Medical Center in downtown Minneapolis.
“It was my very last effort to try to lose weight,” she said.
She’d tried everything before that — from Weight Watchers to the Atkins diet to the grapefruit diet. “I did have some success, but nothing was ever permanent,” she said.
After a national report this summer showed that women have surpassed men in obesity rates, doctors and obesity researchers are searching for answers to why women are struggling more than men.
For the first time, more than 40 percent of U.S. women are obese, according to the Centers for Disease Control and Prevention.
The nation as a whole continues to struggle with obesity, with 35 percent of men considered obese. But, while men’s obesity rates appear to have stabilized, women’s are still rising, the CDC report shows.
Dr. Maria Collazo-Clavell, an endocrinologist at the Mayo Clinic who works with overweight and obese patients, has been working in the obesity research field for 20 years. She said the recent findings give her pause about whether public health officials are taking the right approach to tackling obesity.
“All of that makes you question: Are you on the right track?” she said. “The data would say no.”
That so many women are obese is cause for alarm not only because of the increased health risks for them, but also for those around them, Collazo-Clavell said.
“That’s ... the tip of the iceberg,” she said. Women are often the primary caregivers in a family, and their eating and activity habits can influence their children and others in their family.
An example of that ripple effect: Collazo-Clavell is starting to see some of her previous patients’ children and is working with them to help manage their obesity.
It’s difficult to pinpoint what is causing women to struggle more with obesity than men, but doctors say there likely are many factors at play.
Women typically have two times in their lives when they are at risk of gaining significant amounts of weight: childbearing (during pregnancy and after giving birth) and menopause.
Collazo-Clavell hears from many new mothers that they find meal planning and preparation tough after giving birth. Also of concern, she notes that women as a group are going into pregnancy heavier than they were 20 years ago.
It makes it harder to manage a healthy pregnancy weight if they’re already overweight, she said.
One of the country’s leading health problems, obesity can lead to serious diseases, including diabetes and heart
disease.
Body mass index (BMI) is calculated by dividing weight (in kilograms) by height squared (in centimeters). Anyone with a BMI of 25 or more is considered overweight, while those with a BMI of 30 or more are obese.
For example, a woman of average height in the U.S. (5 feet 4) would be classified as obese if she weighs at least 175 pounds. An average height American man (5 feet 9) who weighs 203 pounds or more would be considered obese.
Dr. Guilford Hartley is medical director of the Hennepin Bariatric Center and Obesity Program, where 100 surgeries for weight management are performed each year.
He sees many more female patients than men. Part of the reason, he said, is that women are more likely to seek medical treatment for a weight issue than men.
“In our culture, when a man’s overweight, nobody pays too much attention,” he said. “But we have such an emphasis on being thin for women that we’re culturally forcing women to be more concerned about their weight than men.”
Those seeking surgery often have struggled with a weight problem for a long time. “Usually, by the time I see them, most of them get here saying, ‘I’ve done this all my life. This is my sixth yo-yo,’” he said.
He found the recent CDC report on obesity rates concerning. “Up until these reports, it was looking as if the so-called obesity epidemic was kind of plateauing.”
In analyzing the new data, Hartley and Collazo-Clavell point to societal changes that have led people to become more sedentary. “If you were a clerical person, 20 years ago, you’d have to get up and put the piece of paper in the file cabinet. Now you never have to get up off your chair,” Hartley said. “We have engineered ... physical activity out of our workplace and out of our home place.”
The prescription of “eat less and exercise more” does not address the kind of vigorous activity needed to tip the scales.
“When we tell them to exercise more, we mean get on a treadmill for an hour, three days a week,” he said. “And the kind of exercise that it takes to have a significant impact on weight is more like if you’re a hardscrabble farmer and you’re working up a sweat for eight hours a day just to put food on the table.”