ABSTRACT
The hormonal changes associated with obesity have a significant impact on endometrial function, embryo implantation, and abnormal proliferation leading to endometrial hyperplasia. Obesity recently has been recognized as a disease by several medical societies. Obesity and insulin resistance may also initiate or worsen polycystic ovarian syndrome (PCOS) and negatively impact fertility and reproductive outcomes in both women with and without PCOS. Obesity increases the risk of insulin resistance and the metabolic syndrome and obesity-associated diseases. The presence of nuclear atypia in patients with endometrial hyperplasia is the most significant indicator of an unrecognized adenocarcinoma. Insulin resistance and diabetes mellitus that are frequently associated with obesity are strong risk factors for endometrial cancer. Obesity is associated with many adverse effects on a woman's general health, reproductive potential, and pregnancy. Although obesity increases risk for insulin resistance, not all obese individuals are insulin resistant, and up to a third may be insulin sensitive.
