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Contraceptive care and treatment for obese or overweight women

Sarah Kipps examines the evidence on advising women with weight issues on the best choice of contraception

The issue of obesity in adults and children is an increasing problem in the UK and across the world, and is challenging every area of healthcare provision. In 2017 the majority of adults in England in 2017 were overweight or obese (64%). Obesity prevalence increased steeply between 1993 and around 2000, with a slower rate of increase after that. Overall, 67% of men and 62% of women were classed as overweight or obese. However, obesity (including morbid obesity) was more common in women than men.1 Obesity in women presents specific challenges for their reproductive function and obstetric outcomes. It also presents a challenge for contraceptive providers with the increase in adverse health issues such as cardiovascular disease and metabolic disorders. Safe and effective pregnancy planning and prevention is critical for women with obesity. Healthcare professionals in primary care and sexual health are ideally placed to raise the topic of weight and signpost women to assist them in achieving a healthy BMI. The Royal College of Obstetricians and Gynaecologists advises that all primary care services should ensure that all women of childbearing age have the opportunity to optimise their weight before pregnancy.2

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