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Obesity rates have been rising in the U.S. Obesity is diagnosed with the body mass index (BMI), which is based on a person’s height and weight. In 2022, nearly 33 percent of women in the U.S. had a BMI score in the obese range, according to America’s Health Rankings.
Although the media and society often emphasize personal behaviors that may contribute to a higher weight, medical experts classify obesity as a chronic neurobehavioral disease with multiple, complex causes.
For some women, having a higher weight increases the risk of serious health conditions like heart disease, type 2 diabetes, and sleep apnea, according to the National Heart, Lung, and Blood Institute. It can also contribute to issues like polycystic ovary syndrome (PCOS), infertility, and mental health challenges.
Tackling these health risks often requires more than diet changes. A healthcare provider can help you create a care plan that considers your physical and mental health. They can help you understand the causes of any health concerns you’re facing and how to improve your overall well-being.
Women’s health is uniquely impacted by body fat distribution, hormones, and cultural factors. According to the Journal of Endocrinological Investigation, men are more likely to develop central obesity, where body fat collects around the abdomen. Women typically have peripheral fat distribution, meaning body fat is stored around the hips, buttocks, and thighs. Extra body fat around the abdomen is associated with health risks, including high blood pressure, insulin resistance, and metabolic syndrome. People with peripheral fat distribution may have a slightly lower risk for these conditions.
Hormonal fluctuations during pregnancy and menopause can increase the risk of obesity, while cultural norms and beauty standards often influence physical activity and eating habits.
Women also face higher rates of weight bias and discrimination, according to a study in the International Journal of Obstetrics and Gynecology. In the U.S., obesity in Black women and other women of color is often met with even greater prejudice, which can negatively impact mental health and access to health care.
Obesity is complex and usually cannot be linked to just one cause. Changes in hormones, metabolism, or behaviors can contribute to body weight fluctuations. A higher body weight may come from a combination of the following factors.
Your genetics play a key role in how your body operates. They influence how you store body fat, when you feel full, and how your metabolism processes energy. Specific genes may predispose you to having a higher body weight. Research has found between 200 and 500 specific genes that affect traits like BMI score, waist-to-hip ratio, and skinfold thickness (how much fat is just under the skin).
Several hormones influence body fat distribution, metabolism, and appetite, directly influencing body weight and related health risks. Higher body weight is associated with imbalances in hormones such as:
Sex hormones, particularly estrogen, significantly impact fat distribution and the risk of obesity-related complications. Before menopause, estrogen encourages fat storage in the hips, a pattern linked to lower disease risk. After menopause, when estrogen levels drop, fat tends to accumulate in the abdomen, increasing the risk of heart disease, type 2 diabetes, and metabolic syndrome.
Lifestyle factors aren’t the only contributors to a higher weight, but they can play a role in increasing risks. The following behaviors are risk factors:
The good news? Lifestyle factors can be changed. With guidance from a healthcare provider, interventions like balanced nutrition, regular physical activity, and stress management can help maintain a healthy weight. Learning easy, nutritious recipes and simple exercise routines can make these lifestyle changes sustainable.
Weight gain and depression are strongly linked, and each can contribute to the other. People experiencing depression have a 58 percent increased risk of developing obesity.
While experts continue to study the relationship between a higher body weight and depression, they know that stress can contribute to both conditions. Prolonged stress plays a key role in this cycle. Chronic stress raises cortisol levels, which can lead to weight gain, emotional eating, and worsening depression. These psychological challenges often contribute to invisible symptoms of obesity, such as low self-esteem, reduced quality of life, and increased risks for chronic diseases.
Members of MyObesityTeam have described their challenges with stress and weight gain. One member shared, “Does anyone else put on weight when feeling very stressed? Seriously, why can’t I be like my skinny sisters? When they feel stress, the weight falls off them.”
Social, cultural, and environmental influences may contribute to a higher body weight, and these are often overlooked. Different cultures have different perceptions of physical attractiveness, traditional foods, and stressors, which can influence body weight. Your family upbringing may also impact your eating habits and behaviors.
Environmental challenges like living in a food desert — an area with limited access to affordable, healthy food — make it harder to maintain a balanced diet.
Some prescription medications affect how your brain perceives hunger and fullness. Others affect your metabolism or how your body stores nutrients. Medications that can contribute to weight gain include:
Talk to your doctor if you notice significant weight gain while taking a new medication.
Obesity can affect your overall health and increase your risk for other chronic conditions.
People with a higher weight may have an increased risk of developing heart disease. Cardiovascular disease is linked with high body fat and chronic inflammation. A lack of regular physical activity is another risk factor for both weight gain and cardiovascular disease.
According to a study in Frontiers in Endocrinology, women with obesity are 12 times more likely to develop type 2 diabetes than the general population. Type 2 diabetes is a lifelong metabolic disease that affects the hormone insulin and causes high blood sugar. It can lead to other long-term health problems including kidney disease, vision loss, and cardiovascular disease.
Obesity is associated with diseases affecting the liver and digestive system, including metabolic dysfunction-associated steatotic liver disease (MASLD) and gallstones.
As previously mentioned, obesity can contribute to depression and vice versa. People with obesity are at a 55 percent higher risk of depression than the general population. Both conditions can increase your cardiovascular disease risk.
Obesity can impact your mental health in other ways too, like lowering your self-esteem and increasing anxiety. These can influence your emotional well-being and social behavior.
Members of MyObesityTeam share support and encouragement about their mental health and self-esteem. One member said, “I’m starting counseling to help my self-esteem, and it really does work.” Another added, “Taking care of my mental health seems to make everything fall into place. Life feels happy and healthy again.”
Obesity can impact reproductive health and contribute to infertility for people of any gender. Higher body weight is linked to polycystic ovary syndrome (PCOS), which is the leading cause of anovulation (lack of ovulation). A higher BMI score, even without PCOS, is also associated with anovulation.
Higher body weight can have broad and unexpected impacts beyond the primary health risks. It can reduce your mobility by causing obesity-related osteoarthritis, a degenerative disease that breaks down cartilage in joints like your knees.
While poor sleep quality can contribute to weight gain, a higher body weight can also reduce your quality of sleep. Obstructive sleep apnea (OSA) causes your upper airway to collapse as you sleep, which disrupts your breathing. OSA is a risk for people with obesity, but it often goes undiagnosed since you may not be aware of breathing problems when you sleep. Look for daytime symptoms of OSA like drowsiness, headaches, and dry mouth when you wake up.
Complications during pregnancy and childbirth are more likely to occur in people with obesity. These can affect the parent or the baby or both. Your obstetrician will closely monitor your pregnancy for these complications:
Talk to your doctor if you have concerns about the health risks of obesity. Your doctor can create a structured and personalized treatment plan to support your long-term health and address possible complications. Treatment often involves interventions like personalized meal plans, physical activity, care for any other health conditions, and even surgery in some cases. Consulting with a healthcare professional will help you ensure a tailored approach to reduce risks and improve overall well-being.
MyObesityTeam is the social network for people with obesity and their loved ones. On MyObesityTeam, more than 55,000 members come together to ask questions, give advice, and share their stories with others who understand life with obesity.
Do you have health concerns related to having a higher body weight? How are you taking care of your health and well-being? Share your experience in the comments below, or start a conversation by posting on your Activities page.
Flaviu Titus Patrascanu, M.D.
is a physician specializing in endocrinology and diabetes, nutritional, and metabolic disorders.
Learn more about him here.
Emily Van Devender
is a freelance health writer based in Portland, Oregon.
Learn more about her here.
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