Do you recall TV commercials depicting women thoughtfully selecting cooking oils to protect their husband’s heart health? However, the Global Burden of Disease Study estimates heart disease to be the leading cause of death amongst women in India, higher than all cancers combined. An often overlooked contributor to this massive burden is obesity, but the conversation on the topic remains largely limited. So, this International Women’s Day, let’s shed light on the profound impact of obesity on women’s heart health.

Among women, obesity is typically defined as having a waist circumference greater than 80 cm and a Body Mass Index (BMI) over 30. NFHS-5 data (2019- 2021) indicates that nearly 2 out of every 5 women suffer from abdominal obesity, putting them at serious risk of cardiovascular ailments. The strong link between obesity and heart disease has long been common knowledge. Obesity elevates cholesterol levels, increases blood pressure, and causes diabetes — all conditions that lead to heart disease. However, new research shows that excess weight on its own can also put a strain on the heart. For women, these risks are compounded by unique challenges. First, heart diseases often manifest differently in women, with subtle and easily overlooked symptoms like discomfort in the jaw or the back. This causes delays in diagnosis and treatment. Even when diagnosed, women may not respond similarly to the treatments as men due to biological, medical, and social differences. Additionally, data from our hospital has shown that women are much less likely to access medical care as compared to men and this worsens at extremes of age and for heart diseases.

Hormonal changes

Furthermore, pregnancy complications like gestational diabetes and high BP are known to increase the risk of heart disease for women. Hormonal changes after menopause also contribute to the heightened risk.

While it is easy to attribute obesity to individual choices or lifestyle factors, the reality is more complex. Cultural norms, socio-economic disparities, and environmental factors all shape our relationship with food and physical activity. For instance, women living in urban areas are affected by sedentary professions and lifestyles, which limit their physical activity compared to their rural counterparts. Furthermore, rapid urbanisation has also resulted in an expansion of ready-to-eat and processed foods. The high quantities of sodium/sugar and preservatives in these items have exacerbated vulnerability to heart diseases.

The way forward lies in making concerted efforts to raise awareness of women’s heart health.

First, it is imperative that women get educated about the subtle symptoms of heart disease. Unexplained fatigue, discomfort in the neck, jaw, shoulder, upper back, or upper belly regions, along with nausea, are some signals that it’s time to visit a physician. Next, regular check-ups are essential to keep tabs on vital numbers such as blood pressure, cholesterol, sugar, waist circumference, and BMI, to catch any potential issues early on. Women should also inform their doctors about any pregnancy complications or conditions like endometriosis or polycystic ovary syndrome (PCOS), as these can increase the chances of heart disease.

Additionally, being physically active for at least 150 minutes every week is crucial. Alongside this, avoiding tobacco, moderating alcohol consumption and adopting a balanced diet are essential steps in mitigating heart disease risk.

In certain cases, medical interventions may be needed to reduce the risk of major cardiovascular events. Emerging treatments like semaglutide offer promising options for those struggling to manage their weight through traditional methods.

As a society, we need to shine a brighter spotlight on women’s heart health. This also requires strengthening access to nutritious food, creating safe and supportive environments for physical activity, and ensuring responsible use of anti-obesity medications.

The writer is Chief, Cardiothoracic Sciences Centre, AIIMS

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