Because of the increased stroke risk seen in women with migraine headaches with aura and smoking, it is reasonable to strongly recommend smoking cessation in women with migraine headaches with aura (Class IIa; Level of Evidence B). Obesity, Metabolic Syndrome, and Lifestyle Factors By the year 2030, an estimated 86% of Americans will be overweight or obese.292 Obesity affects a disproportionate number of women in the United States; in 2007 to 2008, the age-adjusted prevalence of obesity in the United States was 35.2% in women compared with 32.0% in men.293 Non- Hispanic black women have the highest prevalence of obesity The distribution of obesity has important cardiovascular coined the term android obe- sity to describe the high-risk form of obesity, at that time more frequently found in men, in which the body fat is concentrated in the abdominal area; he introduced the term gynoid obesity to describe the low-risk lower-body adiposity, more frequently found in premenopausal women. Abdominal obesity (defined as waist circumference >88 cm in women and >102 cm in men), however, is now far more prevalent in women than men, and android obesity is a misnomer. In fact, data from NHANES in 2007 to 2008 revealed that among adults 20 years old, age-adjusted prevalence of abdominal obesity was 61.8% in women compared with 43.7% in men.293 In addi- tion, premenopausal women are increasingly likely to have abdominal obesity; a recent study of women aged 35 to 54 years in the United States revealed that from 1988 1994 until 1999 2004, the prevalence of abdominal obesity increased The escalating obesity epidemic may counter the tremendous advances that have been made Bushnell et al Guidelines for Prevention of Stroke in Women 1565 in smoking cessation and hypertension and dyslipidemia awareness and control in the United States. 