The impact of overweight and obesity in postmenopausal women

Summary

Recently, Martínez-Vásquez et al. [1] reported the results of a cross-sectional study that aimed to investigate the association between overweight and obesity in postmenopausal women (n=395) and different health related aspects including quality of life, physical activity, and sleep quality, by filling out respectively, the 12-item quality of life short-form survey (SF-12), the International Physical Activity Questionnaire (IPAQ), and the Pittsburgh Sleep Quality Index (PSQI). It was found that a 64.6% were overweight or obese. Binary logistic regression analysis determined that obesity was associated with higher odds of having a lower quality of life, including alterations in physical role and function, pain and vitality. Those overweight/obese had higher odds of cardiovascular problems. Obese women were more likely to develop endocrine problems, suffer of urinary/fecal incontinence, and pelvic pain. The researchers conclude that obesity in postmenopausal women negatively affects perceived quality of life, sleep quality, physical activity, the development of cardiovascular problems and pelvic floor-related problems.

Commentary

Overweight and obesity are considered a public health problem that does not affect equally all population groups. In 2016, 40% of women worldwide were overweight, with an increasing related prevalence of chronic conditions such as diabetes, hypertension, and cancer, all that increase morbidity and mortality [2]. After menopause, at least in part, estrogen deprivation causes changes in body composition that aid to the development of the previous mentioned conditions. Not only does the decrease of estrogen secretion affect weight yet also enhances the appearance of symptoms that negatively impact quality of life, sleep, sexuality and mood [3]. The results of the present study, addressing a sample of postmenopausal women, are not new, perhaps its added value is that it evaluates a Spanish population and combines three validated tools adding assessment of physical activity. During the menopausal transition, women engage in sedentary life style habits which has a negative impact on weight and consequently on the previously mentioned chronic conditions. Reports have highlighted the fact that physical activity improves mental health and physical aspects of general quality of life such as vitality, physical function and role, and even social function [4].

The authors also found a negative impact of pelvic floor related problems, which is in correlation with what has been described by others [3]. Although the authors do not acknowledge study limitations, one can mention its cross-sectional design, that does not allow determining causality and sample size. In any case, as mentioned, the study assesses the impact of a growing health problem (increased weight) in a postmenopausal sample using sound tools simultaneously evaluating various health aspects.

As authors state, it is essential to provide individualized care to postmenopausal women with overweight or obesity to improve their symptoms, normalizing their weight, which in turn would improve quality of life, and prevent the appearance of chronic conditions.

Take home key points

• After menopause, there is a need to increase physical activity, which in turn will have a positive impact in female health.
• Tailored individualized management of menopausal women will provide improvement of quality of life.

Danny Salazar-Pousada, MD
Universidad Católica de Santiago de Guayaquil, Guayaquil Ecuador

References

1. 1. 1. Martínez-Vázquez S, Hernández-Martínez A, Peinado-Molina RA, Martínez-Galiano JM. Impact of overweight and obesity in postmenopausal women. Climacteric. 2023;26(6):577-582.
         https://pubmed.ncbi.nlm.nih.gov/37477988/
      2. Swinburn BA, Sacks G, Hall KD, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011;378(9793):804-814.
         https://pubmed.ncbi.nlm.nih.gov/21872749/
      3. Palacios S, Chedraui P, Sánchez-Borrego R, Coronado P, Nappi RE. Obesity and menopause. Gynecol Endocrinol. 2024 Dec;40(1):2312885.
         https://pubmed.ncbi.nlm.nih.gov/38343134/
      4. Martin CK, Church TS, Thompson AM, Earnest CP, Blair SN. Exercise dose and quality of life: a randomized controlled trial. Arch Intern Med. 2009;169(3):269-278.
         https://pubmed.ncbi.nlm.nih.gov/19204218/

If you would like to add a comment or contribute to a discussion based on this issue, please contact Menopause Live Editor, Peter Chedraui, at  peter.chedraui@cu.ucsg.edu.ec.