Factors contributing to female obesity

Interestingly in comparing body weight in women with men, the former sex is influenced more by nationality, race-ethnicity, and socioeconomic status in comparison to men. This suggests that a closer link exists between body weight and social and cultural roles in women in comparison to men (19).

Ethnicity

Ethnicity also tends to influence obesity. In the United States, non-Hispanic black women were more obese (53%) than Mexican American women (48%) but significantly more obese than non­Hispanic white women (36%). This ethnic influence was not seen in males of the same age group (40-59 years) (19). Where mean age- and BMI-matched women have been used to identify cardio­vascular risk factors, it was noted that African women had higher systolic blood pressures and peripheral vascular resistance in com­parison to Caucasians (20).

Genetics

There is evidence that obesity is more common in genetically sus­ceptible individuals. However, monogenic and syndromic-related CHAPTER 7 Obesity in obstetric and gynaecological practice obesity conditions are relatively rare. Syndromes such as trisomy 21, Prader-Willi, and Beckwith-Wiedemann are relatively uncommon as a cause of obesity. Research into the aetiology of common obesity is fierce, however; genetic susceptibility is complicated by the ability of environmental change to alter gene expression by mechanisms such as methylation (22).

In the majority of individuals, the balance of calorific intake and energy expenditure (physical activity, basal metabolic rate, and thermogenesis) maintains a homeostatic BMI. The hypothalamus regulates energy homeostasis through integrating neural, hor­monal, and metabolic signals from peripheral and central nervous systems, endocrine glands, including adipocytes, and blood metab­olites such as glucose and fatty acids (23). Congenital or acquired causes of dysregulation in any of these pathways have the potential to cause the accumulation of excess energy as lipids. Linkage ana­lysis has revealed single gene disorders as a cause for obesity with mutations in genes such as the leptin-encoding gene, the leptin re­ceptor gene, and pro-opiomelanocortin. These mutations are rare causes of obesity (24).

In the more common form of obesity that we are seeing as an epi­demic, research indicates that although there are around 60 gen­etic factors implicated, only approximately 32 are associated with less than 1.5% of BMI variation between individuals (22). This would mean an average difference of 7 kg between two individuals of similar height/ethnicity/age (14). Therefore for such a common condition, genetics cannot be the prevailing cause for the increasing waistline.

More on the topic Factors contributing to female obesity:

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