Prevalence of and trends in obesity and insulin resistance among US perimenopausal women, 2003-2023

Objective: Obesity and insulin resistance are major public health concerns, especially among perimenopausal women. Accurate estimates of their prevalence and analysis of trends are essential for informing policy decisions, guiding future research, and ultimately improving health outcomes in both perimenopausal and postmenopausal women. Methods: This study included 1,325 perimenopausal women aged 42-59 years from NHANES surveys conducted between 2003 and 2023. Eligibility was based on self-reports of at least one menstrual period in the previous 12 months. This study assessed the prevalence of and trends in general obesity, abdominal obesity, severe obesity, and insulin resistance among perimenopausal women in the United States. Results: From 2003 to 2023, the prevalence rates of general obesity, abdominal obesity, severe obesity, and insulin resistance increased significantly, with rates increasing from 34.9% to 41.4%, 62.5% to 67.0%, 5.2% to 11.5%, and 22.5% to 30.2%, respectively. Logistic regression and Joinpoint analysis confirmed these upward trends. Statistical significance was consistent across the trends in mean BMI, waist circumference, and fasting blood insulin. Furthermore, significant disparities were observed in these trends across sociodemographic subgroups. Conclusions: From 2003 to 2023, there was a significant increase in the prevalence of obesity and insulin resistance among US perimenopausal women, with notable disparities across racial and ethnic groups. Further research is essential to assess the impact of public health interventions on these trends and develop targeted strategies to address the increasing prevalence of these conditions.