The Relationship between Body Weight and Health Care among German Women

OBJECTIVE: To investigate the relationship between body weight and the use of health care services among women from southern Germany. RESEARCH METHODS AND PROCEDURES: Data were drawn from the 1994 to 1995 Monitoring of Trends and Determinants in Cardiovascular Disease Augsburg survey, covering a population-representative sample of women 25 to 74 years old (n = 2301). Logistic regression models were used to calculate odds ratios (ORs) for the use of medical services by women with overweight (BMI 25.0 to 29.9 kg/m(2)) or obesity (BMI >or= 30 kg/m(2)) in comparison with normal-weight women (BMI < 25.0 kg/m(2)). RESULTS: In multivariable analysis, obese women 50 to 74 years old were more likely than normal-weight women to delay cancer screening procedures, such as manual breast examination and Papanicolaou smear (OR 0.52, 95% confidence interval 0.37 to 0.74) in the previous 12 months. However, the relationship between obesity and cancer screening was not found to be significant in 25- to 49-year-old women (OR 0.92, 95% confidence interval 0.62 to 1.36). Neither in the 25- to 49-year-old age group nor in the 50- to 74-year-old age group were independent relationships between higher body weight and total physician visits, hospitalizations, or medication use observed. DISCUSSION: Obese women tended to use medical services with greater frequency due to obesity-related diseases. However, postmenopausal women with a BMI >or= 30 kg/m(2) were more likely to delay routine cancer screening, putting them at a greater risk for death from breast, cervical, and endometrial cancer. Thus, obese postmenopausal women should be targeted for increased screening.