Obesity: A Ticking Time Bomb for Reproductive Health
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Tahir Mahmood, Sabaratnam Arulkumaran (eds). London, UK: Elsevier, 2012. ISBN-13: 978-0-124-16045-3. Price: £95.00. Pages: 500 (hardback)

*   obesity

This book highlights the complexity of obesity and the impact on mental, physical and emotional health. It is very relevant for anyone working in the field of reproductive health as obesity presents specific concerns and challenges for the reproductive health of men and women, affecting fertility, reproduction, pregnancy and their children's long-term health. The prevalence of obesity is increasing globally in all age groups and socio-economic groups and is of significant economic consequence.

This weighty tome is edited by two eminent UK obstetrician/gynaecologists with nearly 100 contributors who share their expert knowledge and experience to consider the impact of obesity on reproductive health from a variety of perspectives.

The book has 46 chapters divided into nine sections that cover Epidemiology; Obesity and Reproduction; Obesity and Male Reproduction; Pregnancy and Obesity; Obesity and Gestational Diabetes; Obesity and Labour; Interventions to Improve Care of Women During Pregnancy; Long-Term Impact of Obesity; and The Future Research and Health Service Planning. All the chapters are evidenced-based, with references provided at the end of each chapter.

The book begins by exploring the epidemiology of obesity and considers genetic, environmental and psychological factors. Propensity to obesity is examined together with its negative health impact in both adolescence and adulthood.

Specific chapters focus on issues relating to male and female reproduction that may be of particular interest to sexual and reproductive health professionals. Contraception, sexual health, miscarriage, infertility and assisted reproduction are considered in relation to obesity. It is refreshing that Section 3 is dedicated to male reproductive health including the impact of obesity on sexual dysfunction, semen quality and a chapter examining bariatric surgery and male reproductive function.

Complications of maternal obesity in relation to pregnancy and labour are comprehensively covered in Chapters 14–30. Risks of pregnancy are examined both for the mother (morbidity and mortality, pre-eclampsia, venous thrombosis, gestational diabetes, anaesthetic issues) and for the child (abnormalities, stillbirth, poor growth and impending damage to future health through epigenetic mechanisms).

Interventions are discussed in order to improve care for obese women and include anti-obesity drugs and bariatric surgery in the preconception period and a multi-modal framework and standards of care once pregnant.

The book then considers the long-term effects of obesity on health including gynaecological perspectives on menstrual disorders, hormone replacement therapy and female malignancies. Final chapters look at lifestyle issues, public health and health service provision for obese women to enable joined-up care. The editors conclude with recommendations for future research.

This is a truly comprehensive resource for those working in the field of reproductive health and care including health care professionals, students and researchers. The breadth of topics covered underlines the complexity of obesity, and professionals need to be aware of the many areas of reproductive health that may be affected. The book is easy to read and is available as a Kindle download and as a hardback edition. Due to its size and cost the hardback text may be more appropriate as a reference book in departments and libraries.