Increased weight and BMI is associated with the increased prevalence of hormonally driven endometrial pathology regardless of menopausal status, according to research presented at the American College of Obstetricians and Gynecologists' 58th Annual Clinical Meeting in San Francisco. Researchers at the University of Virginia at Charlottesville conducted a retrospective review that identified women who underwent endometrial biopsy at their institution between the years 2007 and 2009. Ninety‐five abnormal biopsy results were identified and correlated with normal controls at a ratio of 1:4. Data regarding demographics, biopsy indications, and pathologic diagnoses were obtained and compared based on BMI classification. Type I hormonally‐driven pathology was defined as complex atypical hyperplasia and endometrioid endometrial adenocarcinoma, International Federation of Gynecology and Obstetrics (FIGO) grade 1/2. All other uterine cancers were classified as Type II. Six hundred and twenty‐three women were included with a mean age of 50.34 years, weight of 89.24 kg, and BMI of 33.55. Abnormal bleeding was the predominant indication for biopsy (79.5%); the most common pathologic diagnoses on biopsy were proliferative phase, secretory phase, and atrophy. The University of Virginia researchers found that women with hyperplasia or cancer were significantly heavier than women with benign findings (96.4 kg vs 87.9 kg, P =0.008). Body mass index showed a similar trend (35.4 vs 33.2, P=0.08). The prevalence of Type I pathology was increased in women with a BMI greater than 40 with an odds ratio (OR) of 1.99 (95% confidence interval [CI], 1.05 to 3.74), and this increase was even more dramatic for women older than 50 years (OR, 2.89; 95% CI, 1.27 to 6.54).