Guest Post: Why Gynecologists Should Learn About Obesity MedicineThursday, June 9, 2022
Today’s guest post comes from Emilia Huvinen, MD, PhD, Gynecologist, Helsinki, Finland
My first step into the world of obesity research and care began with my PhD studies on gestational diabetes.
For a young gynecologist, it was all new in the beginning but soon I found myself immersed in the world of behavioural medicine, adiposity and glucose metabolism. As years went by, and I learned more and more about different aspects of healthy behaviours and the complex biology of weight regulation, I finally got involved in actually treating women with obesity for their obesity.
As a gynecologist, it is not difficult to see how obesity can play a crucial role in several periods of a woman’s life; starting from having early puberty and continuing to heavy menstrual bleeding, infertility, pregnancy complications, and stronger menopausal symptoms. Treating obesity can also be beneficial when treating women with polycystic ovaries syndrome (PCOS), infertility and endometrial hyperplasia, a pre-stage of uterine cancer. As obesity is associated with several pregnancy complications, helping our patients better manage their weight preconceptionally can improve pregnancy outcomes and hopefully even influence the health of the next generation.
As a gynecologist, being the trusted long-term doctor for women, we have the privilege of being really close to our patients’ lives. We are also very used to discussing intimate and even very delicate issues in our everyday practice. However, it is apparently still a million-dollar-question how to get more gynecologists involved in obesity care.
Unfortunately, the general advice currently given to women living with obesity is still to just “eat less and exercise more”. Many of us are still unaware that obesity is a chronic disease, and that people need care and treatment, not guilt and accusations.
I suspect that the most common obstacle preventing more gynecologists getting involved in obesity medicine, is simply lack of information. Starting a conversation on obesity feels uncomfortable and delicate, and there’s a general assumption that specific skills are needed that are best left to obesity specialists. Often it is also a question of time, and many feel that it might not be worth the effort. For gynecologists, medications for obesity treatment are also unfamiliar and different from the ones we typically use.
My wish is to develop a sustainable and practical protocol for treating and supporting my patients living with obesity. Developing multi-professional networks together with skilled dietitians and psychologists is crucial. I also believe that by using electronic technologies like video consultations, we can offer better access to obesity care even to women living in remote areas – which in Finland is not uncommon!
Even if most gynecologists currently may not feel comfortable treating obesity, I hope we can at least all talk to our patients in a sensitive way and support and guide our patients with obesity to places where care is offered. We should also acknowledge that as doctors we often play a major role in creating obesity stigma.
As new and highly effective treatments for obesity are now becoming available, I clearly see a golden opportunity for us as gynecologists to become more involved in obesity medicine as part of our practice. Our patients certainly deserve comprehensive care, which includes helping them better manage their obesity.
Dr Emilia Huvinen,
About the author: Dr Emilia Huvinen, MD PhD, is a specialist in Obstetrics and Gynecology and currently works as an OBGYN in Aava clinic and treats women with obesity in weightclinic.online. She’s also a postdoctoral researcher at University of Helsinki. Her PhD studies focused on heterogeneity of GDM and long-term health of GDM women, but in recent years her research has expanded from lifestyle and pregnancy to metabolomics and genetics and their interplay in the health of women and their children.