Guest post by Kate Davies
Many women are aware of the negative affect that being overweight can have on their health, but they rarely think about the impact that it can have on their fertility. That is, until they want to start conceiving…
In today’s society of fast food and busy lives, obesity worldwide has reached epidemic proportions. Recent research, in both the UK (Scantlebury and Moody, 2015) and the US (Flegal et al. 2016) has identified that more obesity is seen in women as opposed to men. This new research raises concerns for female infertility for both now and in the future.
What is obesity?
Obesity is characterised by excess adipose tissue and can be classified based on Body Mass Index (BMI), that is the current preferred measurement to determine weight (WHO 2016). A BMI of 18.4-24.9 equates to normal weight, overweight is considered to be between 25-29.9, obese is 30-39 .9 and a BMI > 40 indicates morbidly obese.
You calculate your BMI by dividing your weight in kilograms by the square of your height in metres or by using an online BMI Calculator.
The cause of obesity may not only be due to poor lifestyle choices but may be in-relation to underlying conditions such as diabetes, hypothyroidism and PCOS.
In North America, 50–75 % of women with PCOS are obese (Yildiz et al. 2008) and in the UK this prevalence is 40% (Balen 2006).
How does obesity affect my fertility?
Women of child bearing age with a BMI of 30 or greater are likely to take longer to conceive, as an increasing BMI is associated with menstrual disturbances such as irregular cycles and infrequent or complete lack of ovulation.
There is good evidence that obesity lowers the success rates of in vitro fertilization (IVF). Studies have shown lower pregnancy rates and higher miscarriage rates in obese women and obese women are at an increased risk for developing pregnancy-induced (gestational) diabetes and high blood pressure (pre-eclampsia). Obese women also have a higher chance of delivering by cesarean section and having complications during labor. In addition, children of obese mothers are at an increased risk of birth defects and being born with a high birth weight.
For women suffering with PCOS, their ability to conceive is further compounded with hormone imbalance often due to insulin resistance, which in turn effects ovulation.
How can I lose weight?
Studies have shown that weight loss can lead to successful pregnancies. Even as little as 5% weight loss leads to increased ovulation rates (Norman 2004) and a decrease in raised androgen levels that are responsible for acne, excess hair growth and male pattern baldness in women with PCOS.
While it is essential that you lose weight for fertility, you must do so in a healthy way to prevent other complications, which could exacerbate your ability to conceive. Binge or fad dieting is not a healthy way in which to lose weight and can result in nutritional deficiencies.
With a healthy eating plan, you’ll be on your way to a healthy weight. To do so, you may choose to seek the guidance of your doctor, health coach or nutritionist. You will also need to establish a healthy exercise routine, as very often healthy eating isn’t enough to lose the weight you need. A combination of exercise and healthy eating and ideally the support from a qualified practitioner, has been shown to dramatically reduce weight loss when trying to conceive (Agha et al 2014).
Within only a few months, you’ll start to see the benefit that losing weight and exercising has on your general health and wellbeing and crucially your menstrual cycle. You’ll find that your cycles, that were once lengthy and irregular, are becoming shorter and more regular. What’s more, if you are tracking your cycles by monitoring your temperature and other fertility indicators, you’ll start to see an ovulation pattern. What could be greater motivation for weight loss?
7 Tips for Losing Weight for Fertility
- Get Help – Find a qualified practitioner to work with to help you create your weight loss program. Just like there is no one set of symptoms for PCOS, there is no set diet and exercise program that will help all women with PCOS lose weight. You are a Diva, an individual! You need a plan that works specifically for you. Maybe you need less dairy and more cardio. Maybe going gluten-free and yoga works for you. Your health plan must be individualized for you. That means there will be a lot of trial and error. A certified health coach, nutritionist, trainer or other professional can help you find the right path for you!
- Find support – It is so much easier to lose weight and exercise with other people. Get your partner or friends involved. Work out together and support each other with healthy eating. Studies show that women who work out with a partner stick to their plan longer and have more success, plus it’s more fun! Get motivation by joining a program that stresses community like Jumpstart, a weight loss group or online forums.
- Exercise needs to be fun and convenient – Choose an exercise that you enjoy doing, whether it be walking, running, cycling or a zumba class. Consider interval training and adding a little weight training to your routine. Studies show great results with both for women with PCOS! All movement counts. Do you love dancing, gardening, hiking, playing tag with your kids? Do something you love that keeps you moving and it won’t feel like work. Importantly, exercise needs to be convenient to stay on track. What exercise could you do in your lunch break or on your way home from work?
- Stop and think – what you eat or drink is your choice. Stop and think, and make a conscious decision before you tuck in. Some women have success keeping a food journal about what they eat and how it makes them feel. If you write down everything you eat, you may notice patterns. For example, Amy realized that she was picking from her kids’ snack plates and that eating dairy made her uncomfortable and bloated.
- Identify your eating triggers – A bad day at work or another month when you realize you haven’t conceived can often be emotional triggers that lead to overeating. Be a step ahead and prepared for these days. What else could you treat yourself to after a bad day that doesn’t involve food? I call this my sweet stuff list. I try to reward myself with a hot bath, a manicure or an extra few minutes with my book. What works for you?
- Shop smart – Plan ahead and make sure you shop for all the food you need for your weekly menus. Pack your work lunches before you leave the house in the morning. Buy or make healthy snacks for when you need that extra boost.
- Be flexible – Planning ahead doesn’t mean that you can’t also be flexible. Sometimes you might find yourself in a position where you can’t avoid eating what’s in front of you. Just know that you are always one choice away from being back on track.
Above all, start with small changes and be kind and patient with yourself.
Kate Davies is a fertility practitioner, fertility coach and columnist. Kate works with women wishing to optimise their ability to conceive naturally and coaches women going through a difficult fertility journey.
Kate is a registered nurse specialist and worked for over 20 years in the UK’s National Health Service as a specialist nurse in Gynaecology, Sexual and contraceptive health and fertility. Four years ago Kate, frustrated with the lack of support and high quality advice for women who were struggling to conceive, founded her private practice ‘Your Fertility Journey’. Shortly after this, she trained as a fertility coach to offer her patients much needed emotional support as well as medical advice. Kate now has a thriving practice and consults women nationally and internationally via the wonders of Skype.
Kate has a special interest in PCOS and over the years has worked with 100’s of women who suffer with this debilitating condition. To enhance her practice, Kate has recently undertaken specialist training to enable her to offer women both the specialist advice and emotional support they desperately need.
Kate loves her job and her best days are when one of her lovely ladies calls her to say she is pregnant. Often she is the second person to know – what a privilege! Kate is very proud of the Facebook Support Group she founded over two years ago. This group, full of inspirational ladies going through all sorts of fertility journeys, gives ladies a safe place in which to ask advice, find support and get virtual hugs.
As well as her natural fertility and coaching services, Kate is also passionate about Natural Contraception and teaches women internationally on how to use this effective, safe and natural method of contraception.
Facebook Support Group: https://www.facebook.com/groups/Yourfertilitysupportgroup/
Agha, M., Agha, R.A. and Sandell, J. (2014) ‘Interventions to reduce and prevent obesity in Pre-Conceptual and pregnant women: A systematic review and Meta-Analysis’, PLoS ONE, 9(5), p. e95132. doi: 10.1371/journal.pone.0095132.
Balen, A.H. (2006) ‘Should obese women with polycystic ovary syndrome receive treatment for infertility?’, BMJ, 332(7539), pp. 434–435. doi: 10.1136/bmj.332.7539.434.
Norman, R.J. (2004) ‘Improving reproductive performance in overweight/obese women with effective weight management’, Human Reproduction Update, 10(3), pp. 267–280. doi: 10.1093/humupd/dmh018.
Ogden, C.L., Flegal, K.M., Margaret D P H Carroll and Cheryl D P H Fryar (2015) Prevalence of obesity among adults and youth: United States, 2011–2014. Available at: https://www.cdc.gov/nchs/data/databriefs/db219.pdf (Accessed: 12 January 2017).
Scantlebury, R. and Moody, A. (2015) HSE: Adult obesity and overweight. Available at: http://content.digital.nhs.uk/catalogue/PUB19295/HSE2014-ch9-adult-obe.pdf (Accessed: 12 January 2017).
WHO (2016) Obesity and overweight. Available at: http://www.who.int/mediacentre/factsheets/fs311/en/ (Accessed: 12 January 2017).
Yildiz, B.O., Knochenhauer, E.S. and Azziz, R. (2008) ‘Impact of obesity on the risk for Polycystic Ovary syndrome’, The Journal of Clinical Endocrinology & Metabolism, 93(1), pp. 162–168. doi: 10.1210/jc.2007-1834.