Obesity is an increasing problem in the United States; women/men of a reproductive age are not excluded from this problem. It is estimated that approximately 31% of white women, 38% of Hispanic women, and 49% of black women in the U.S. are overweight or obese. Many people are aware of the problems that obesity can cause – but many are not aware of the reproductive consequences.
Infertility in obese women is often (but not always) caused by ovulation problems – ovulation may be occurring very infrequently or not at all. Thus, women may have increasingly irregular/erratic menstrual cycles or no menstrual cycles at all. However, there is some evidence that this is not the only way that fertility can be affected. Although it is not known for sure, some research suggests that elevated levels of insulin (the hormone that allows the body to use glucose effectively) in overweight/obese women may be another factor which reduces fertility.
Studies done on women who have undergone IVF have, in general, shown there to be an adverse effect of carrying extra weight on the success of treatment. These studies also indicate a higher risk of early pregnancy loss for overweight or obese women undergoing IVF.
What is known for sure is that obesity increases the risk of many complications of pregnancy: pre-eclampsia, gestational diabetes, and need for c-section. The risk increases with the BMI (body mass index). Also, obesity has been linked to an increased risk of birth defects. In addition, there are concerns about the impact that maternal obesity may have on the subsequent development and health of the child.
Some providers believe that women should achieve a BMI of 30 who are not achieving results with lifestyle changes alone, some medications may be helpful in enhancing weight loss. For women (or men) who have a BMI >40 (or over 35 with serious co-existing medical problems), weight loss surgery may be a better and more efficacious option.
Addressing weight issues is never easy. Many folks may have already tried weight loss in the past with mixed results. However, the potential benefits for reproductive health are significant. Now is the time to make changes for a healthier you and a healthier pregnancy!