Body mass index and risk of liver cirrhosis in middle aged UK women: prospective study

Objective: To determine the relation between body mass index (BMI) and liver cirrhosis and the contribution that BMI and alcohol consumption make to the incidence of liver cirrhosis in middle aged women in the UK. Design: Prospective cohort study (Million Women Study). Setting: Women recruited from 1996 to 2001 in NHS breast screening centres and followed by record linkage to routinely collected information on hospital admissions and deaths. Participants: 1 230 662 women (mean age 56 years at recruitment) followed for an average of 6.2 years. Main outcome measures: Relative risk and absolute risk of first hospital admission with or death from liver cirrhosis adjusted for age, recruitment region, alcohol consumption, smoking, socioeconomic status, and physical activity. Results: 1811 women had a first hospital admission with or died from liver cirrhosis during follow-up. Among women with a BMI of 22.5 or above, increasing BMI was associated with an increased incidence of liver cirrhosis: the adjusted relative risk of cirrhosis increased by 28% (relative risk 1.28, 95% confidence interval 1.19 to 1.38; P<0.001) for every 5 unit increase in BMI. Although the relative increase in the risk of liver cirrhosis per 5 unit increase in BMI did not differ significantly according to the amount of alcohol consumed, the absolute risk did. Among women who reported drinking less than 70 g alcohol per week, the absolute risk of liver cirrhosis per 1000 women over five years was 0.8 (0.7 to 0.9) for those with a BMI between 22.5 and 25 and 1.0 (0.9 to 1.2) for those with a BMI of 30 or more. Among women who reported drinking 150 g alcohol or more per week, the corresponding figures were 2.7 (2.1 to 3.4) and 5.0 (3.8 to 6.6). Conclusions: Excess body weight increases the incidence of liver cirrhosis. In middle aged women in the UK, an estimated 17% of incident or fatal liver cirrhosis is attributable to excess body weight. This compares with an estimated 42% attributable to alcohol

Why are women buying GOOP? Women’s health and the wellness movement

The questions that have animated the women\u27s health movement for the last half‐century—questions of autonomy, expertise, authority—appear to be bubbling up again on social media, as feminist health journalists, celebrity gynecologists, and wellness moguls once again debate the role of health and medicine in women\u27s lives. The tensions inherent in these debates were nicely captured when journalist Jennifer Block published her commentary titled “Doctors Are Not Gods” in Scientific America at the end of November 2019—and put Twitter\u27s favorite gynecologist Dr Jennifer Gunter in her crosshairs. Few anticipated the mayhem that ensued. To recap, feminist health journalist Jennifer Block argued that Dr Jennifer Gunter—with her New York Times column on women\u27s health, her best‐selling book “The Vagina Bible,” and her robust online following—had crossed a line from friendly Twitter gyno to Internet bully. Block accused Gunter (and, broadly, medical professionals) of “gaslighting” women who partake in the wellness movement. In the hasty, arm wrestling that ensued what was lost was more than just another squabble over Gweneth Paltrow\u27s GOOP and whether or not those jade eggs belong in women\u27s vaginas. Instead, the rancor that has accompanied debates about conventional medicine versus the wellness movement has foreclosed the opportunity to engage in a broader discussion about the role of women\u27s experience in women\u27s health, and what is at stake when women do not feel heard