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Extreme Obesity in Women and Associated Risks
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To the Editor: In their stratified analysis of mortality associated with extreme obesity in women, Dr McTigue and colleagues1 demonstrate the increase in cardiovascular risk that is related to increase in body mass index (BMI). They conclude that more precise stratification of health risk by weight "may . . . assist women in making informed decisions about their health." I question how relevant the precise difference is.
The authors mention potential benefits of this stratification, but there are also risks. Women with a BMI between 30 and 39 may (inappropriately) find justification for minimizing lifestyle changes. Women in the extremely obese category (BMI  40) may feel pressured into higher-risk means of losing weight, such as gastric bypass surgery or "crash diets," before trying more conservative measures. The US Preventive Services Task Force (USPSTF)2 recommends that clinicians use BMI to determine morbidity and mortality risk due to obesity, but they do not specifically advocate the . . . [Full Text of this Article]
Jennifer Middleton, MD
middletonjl@upmc.edu
Department of Family Medicine
University of Pittsburgh
Pittsburgh, Pa
RELATED LETTER
Extreme Obesity in Women and Associated Risks—Reply
Kathleen McTigue
JAMA. 2006;296(18):2205-2206.
EXTRACT
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RELATED ARTICLE
Mortality and Cardiac and Vascular Outcomes in Extremely Obese Women
Kathleen McTigue, Joseph C. Larson, Alice Valoski, Greg Burke, Jane Kotchen, Cora E. Lewis, Marcia L. Stefanick, Linda Van Horn, and Lewis Kuller
JAMA. 2006;296(1):79-86.
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