Healthy Weight

Healthy Weight Matters

Obesity is an overwhelming health concern in our nation and state. In 2008, nearly two-thirds (65.7 percent) of adults in North Carolina were either overweight or obese. From 2001 to 2008, the proportion of NC adults who were overweight or obese increased from 58.8 percent to 65.7 percent. That’s an increase of more than 1,006,894 people! 1

Furthermore, the link between a woman’s weight status and her health during pregnancy, as well as the health of her baby, is well-established. Studies show that a woman’s Body Mass Index (BMI) is linked to adverse maternal outcomes during pregnancy, adverse maternal outcomes during labor and delivery, and adverse fetal/neonatal outcomes. In general, the higher a woman’s BMI, the greater her risk for poor birth outcomes.

Several risk factors are correlated with an overweight or obese BMI2. An increased pre-pregnancy BMI is associated with increased risk of:

  • Preeclampsia
  • Gestational diabetes
  • Gestational hypertension
  • C-section
  • Induction of labor
  • Postpartum hemorrhage

And risks to the baby are also very real. Those health complications include:

  • Macrosomia
  • Preterm delivery
  • Poor Apgar scores
  • NICU admission
  • Shoulder dystocia
  • Late fetal death
  • Neural tube defects (NTDs)

According to the most recent data, 28 percent of women in their childbearing years are obese and 26 percent are overweight. African American women are at especially high risk, with 42 percent being obese and 33 percent being overweight. With such high rates of overweight and obesity among women of childbearing age, interventions are required on many levels of society.

As a health professional, you are an important motivator to change patient behavior. Recent studies have demonstrated that recommendations and counseling from a health professional can play a significant role in patients’ attempts to lose weight, in the prevention of future weight gain, and in increased patient perception of their own weight.  However, only 45 percent of individuals with a BMI of 25 or greater and only 66 percent of those with a BMI of 30 or greater reported being told by a doctor they were overweight.

Patients value the opinion of their health care provider. Talk to your patients about their BMI and how increased BMI is associated with risk for many chronic diseases.

Healthy Habits for Life

Our newest health education project focuses on addressing weight through BMI education and using simple strategies to improve health. The North Carolina Preconception Health Campaign is proud to provide “Healthy Habits for Life,” a consumer education and awareness campaign focused on overweight and obese women ages 18-24.

To this end we have revamped our health care provider in-service, called the Office Champion Program. We now offer public and private health care practices an in-service training to discuss preconception health, healthy weight, and BMI. At these trainings we will provide you with free tools you can use to implement the program. These tools include:

  • Healthy Habits for Life booklets – This interactive booklet is the perfect tool to use with patients. It is based on the Eat Smart, Move More strategies and provides BMI guidance.
  • Healthy Habits for Life poster – Hang up this consumer-focused poster in waiting areas, exam rooms, and patient bathrooms. The poster contains a BMI chart and the adapted Eat Smart, ove More strategies for individual health behavior change.
  • BMI charts – We offer two kinds of full-color BMI charts for your practice. One is a large laminated chart that you can hang near scales and triage areas. The other is a handy letter-sized chart to be used as handout or reminder.
  • BMI calculator plus gestational wheels – These two-for-one wheels are the perfect tool for the busy provider. One side contains an accurate BMI calculator, and the other has a gestational wheel with the most recent recommendations for pregnancy weight gain.
  • Consumer incentive items – This year we are offering reusable grocery bags as consumer incentives to adopt healthy habits. These are available through our regional coordinators.

What is a healthy weight?

A weight range that correlates with a less-than-average risk for health conditions, like heart disease, type 2 diabetes, high blood pressure, stroke, breathing problems, arthritis, gallbladder disease, osteoarthritis, and some cancers3.

Why BMI?

The Body Mass Index (BMI) is an objective way to start the conversation about a patient’s weight. It avoids placing judgment or criticism on a patient, and it allows you as the provider to remain neutral. And while the BMI isn’t perfect, it does provide a good indication of the health risks that a woman may face if she is in a specific category. For example, we know that having a BMI in the overweight category raises the risk of having health problems like heart disease, type 2 diabetes, high blood pressure, stroke, breathing problems, arthritis, gallbladder disease, osteoarthritis, and some cancers3.

And fortunately, using BMI to counsel women of childbearing age is well received. In focus groups that we conducted around the state, we found that young women ages 18-24 were impacted by seeing their BMI on a chart. Combined with the words “overweight” and “obese” their awareness of their weight was raised, and they felt motivated for change.

The Healthy Habits

Our Campaign materials focus on key individual health behavior strategies, called Healthy Habits. These strategies were adapted from the North Carolina Eat Smart, Move More behavior strategies to reduce obesity. Those evidence-based strategies were developed after a rigorous review of current literature and recommendations. Those resources can be found at www.eatsmartmovemorenc.com/TheEvidence/TheEvidence.html.

The Healthy Habits strategies used in our materials are:

  • Rethink your drink.
  • Tame the tube and get moving.
  • Right-size your portions.
  • Choose to move more every day.
  • Enjoy more fruits and veggies.
  • Prepare more meals at home.
  • Breastfeed your baby.
  • Take a multivitamin every day.
  • Track it.

Did you know?

The North Carolina Preconception Health Campaign provides free in-service presentations to health care providers in North Carolina. For more information about our healthy weight trainings, please contact us.

A provider training on healthy weight is also available from the NC Department of Public Health. Click here to download the slides.

Sources:
  1. BRFSS, 2008. BRFSS is an ongoing, population-based, randomized survey of state residents aged 18 and older in households with telephones. Information is collected on a variety of health behaviors and preventive health practices related to the leading causes of death and disability such as cardiovascular disease, cancer, diabetes and injuries. It is conducted by the NC State Center for Health Statistics.
  2. Kellner, S. Maternal Weight: An opportunity to impact infant mortality in North Carolina. 2010, unpublished.
  3. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. National Institutes of Health. NIH Publication NO. 98-4083, September 1998.