Guidelines focus on preventing weight gain, obesity in middle-aged women

The Women’s Preventive Services Initiative — or WPSI — issued new guidelines for preventing weight gain in women aged 40 to 60 years.

The guidelines, which were published in Annals of Internal Medicine, recommend that clinicians should counsel women with normal or overweight BMI on maintaining their weight or limiting weight gain to prevent obesity.

“The WPSI’s recommendation fills a gap in current recommendations by targeting a specific risk group and specifying individual counseling based on its effectiveness and applicability in primary care settings,” Amy G. Cantor, MD, MPH, lead author of the evidence review and assistant professor of medical informatics and clinical epidemiology at Oregon Health & Science University in Portland, Oregon, told Healio. “Currently, there are no clinical recommendations on preventing obesity among women with normal weight or overweight BMI, specifically.”

To counsel this population, clinicians should promote healthy eating and physical activity, according to the guidelines.

“Normalizing counseling about healthy diet and physical activity by providing it to all midlife women may mitigate concerns about weight stigma resulting from only counseling women with obesity,” Cantor said.

In their review of seven randomized controlled trials, Cantor and colleagues found that four out of five studies investigating a counseling intervention had statistically significant favorable weight outcomes. The other counseling intervention trial and the two exercise intervention trials did not have statistically significant weight outcomes.

Additionally, one of two studies that evaluated quality of life reported improvements in physical function and mental health at 12 and 24 months after counseling and exercise prescription compared with counseling alone. In one study, depression and stress did not increase because of the interventions. Another study assessing self-reported falls and injuries found both were more likely with exercise counseling.

“Future research could help identify optimal behavioral interventions that are effective, feasible and sustainable, and can be implemented in primary care settings among diverse populations,” Cantor said. “Studies could evaluate how to improve the training of clinicians and educators providing counseling (for example, clinical staff, nurses, physicians, dieticians); evaluate the role of technology; tailoring interventions to specific populations; understanding the interaction of social determinants of health; delineating the appropriate body composition measures for different populations; determining harms and obtaining direct evidence of long-term health outcomes.”

References:

• Cantor AG, et al. Ann Intern Med. 2022;doi:10.7326/M22-0160.
• Chelmow D, et al. Ann Intern Med. 2022;doi:10.7326/M22-0252.