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Topic: The Impact of Obesity

Robert Rubino:  Well, I mean obesity I think, you know, has the same overall health effect as smoking as far as all the different end organs that it contributes to.  In my particular profession, I worry about it, you know, for pregnant women for gestational diabetes and hypertension and birth trauma and things like that.  For my patients who are trying to get pregnant, a body mass index, which is kind of a metric of obesity, we see a lot more infertility, and in the post-childbearing and postmenopausal women, it increases their risk for again cardiovascular disease, the one thing that I think often doesn’t get the same media play, and it’s almost like, you know, it’s breast cancer for women and cardiovascular disease for men.  No, it’s cardiovascular disease for men and cardiovascular disease for women and then we go to the cancers as far as importance in their incidents.  And we also see endometrial cancer is tied very much to obesity because peripheral fat converts women’s testosterone into estrogen and then can bombard uterine tissue with extra estrogen in the postmenopausal years.  So that’s the typical woman we may see an endometrial cancer in.  So yeah, it’s something I always counsel my patients about.  I do a body mass index on everybody who comes in.  And now we even do our bone densities in the office and we have software we’re able to give them body fat analysis.  And, you know, I think folks when they have an objective measurement of something, it’s something they can work with more than just, “Gee, I’m overweight.”  And so we always try to impact that. I always bring up the issue of obesity because it is so prevalent and you always have to be delicate, but I also try not to avoid the issue with the patients.  And I think most folks, if you bring it up appropriately they’re kind of relieved that you do.  And, you know, I have six sisters so I’ve had a lot of practice in dealing with sensitive issues with women and that’s one that they always tell me about.  No woman ever wants to be told that they’re overweight, which is true, but you also need to bring it up in the context of their healthcare and most folks are fine with it and appreciate the counseling.

Recorded on: 04/29/2008



The Impact of Obesity

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