Obesity is endangering women’s health and that of their babies, the chief medical officer has warned in a report which aims to put to rest for ever the myth that pregnant women should eat for two.

Prof Sally Davies looks across the spectrum at women’s health, from the effects of violence and female genital mutilation (FGM) to eating disorders, cancer survival and the menopause, but she says there is one underlying major concern across the lifespan. Obesity will shorten women’s lives and there is a danger that their children will be stillborn or grow up with health problems themselves, such as obesity, diabetes and high blood pressure.

“In women obesity can affect the outcomes of any pregnancies they have and the health of any future children they may have,” says Davies in her annual report. “This is a difficult message to convey, as it risks burdening women with guilt and responsibility, but I believe that it can also empower women to take positive steps like eating more healthily and taking more exercise. It is never too late to take action for a healthier lifestyle – for you and your family.”

Half of all women aged 25 to 34 are overweight or obese. So are 36% of 16- to 24-year-olds. When women in this age group are trying to get pregnant, they may mention it on a visit to see the GP or a nurse. That is a critical time to start the dialogue about their weight and mental and physical health, says Davies, but opportunities are too often missed.

Pregnancy is not a time to eat more but a time to stay fit, she says. She appeals to women wanting to have children to increase the amount of fruit and vegetables they eat, avoid eating too much, stop smoking, keep off alcohol and stay active.

But obesity is not just a matter of individual responsibility. The first of 17 recommendations in her report is that the government should include obesity in its national risk planning. “Obesity has to be a national priority,” says Davies. “Action is required across all of society to prevent obesity and its associated problems from shortening women’s lives and affecting their quality of life. We need to address the educational and environmental factors that cause obesity and empower women and their families to live healthier lives.”

Davies does not mention the option of a sugar tax, which is supported by Jamie Oliver and many health and medical organisations, although the report notes that “interventions to alter ‘choice architecture’, such as product labelling, sizing and placement in retail outlets” can influence the behaviour of shoppers.

Young women with eating disorders such as anorexia and bulimia are not always getting the treatment they need, according to the report, which says it is disappointing that the NHS is struggling to provide them with psychological therapies that have been proven to work.

Davies recommends that all those with eating disorders should get prompt access to evidence-based enhanced cognitive behaviour therapy (CBT-E) and family-based therapy.

Doctors and campaigners for an estimated 725,000 people with eating disorders in the UK were delighted by this recommendation. Lorna Garner, chief operating officer of the eating disorder charity Beat, said it had long campaigned for access to therapies that have been shown to work. “We are greatly encouraged by this recommendation from the chief medical officer that if implemented will have a dramatic and positive impact on a very large proportion of the individuals diagnosed with eating disorders,” she said.

The CMO said women should not have to suffer in silence from conditions that are considered embarrassing or taboo, such as urinary or faecal incontinence as a result of childbirth, which they should be able to discuss with their doctor because there are treatments.

Among a range of other recommendations to improve the health of women were:

• Medical staff should be trained to recognise and respond to FGM, domestic abuse and sexual violence.
  
• Employers should make it easier for women to discuss the menopause in the workplace and get support.
  
• A national audit of results from ovarian cancer surgery is needed. Longer surgery to remove as much as possible of the tumour leads to better survival, and the UK has some of the worst survival rates in the OECD at 36% over five years.
  
• Children should routinely get sex education and relationship guidance in school, if necessary on a statutory basis.