Obesity and Fertility Problems

Among the top reasons patients in their 20s and 30s seek my help in losing weight is the desire to have a baby. Some women have had irregular periods for years (a tip off for conception problems), with their doctors telling them it’s weight-related. For others, they’ve had regular periods for years, but just don’t seem to conceive, whether the old fashioned way, or with fertility-drug treatment. What’s the connection between obesity and fertility, and how can your diet and lifestyle influence fertility? That’s the topic of my TODAY segment (check back for the video clip).

First, let’s look to Mother Nature: Women on both the very thin and very heavy ends of the weight spectrum have trouble getting pregnant. While the absolute science is not yet here to tell us why, there are a number of scientific observations that point us in a direction of how to manage this problem, and marry both lifestyle and medical treatments to treat fertility problems not related to anatomical issues (liked blocked fallopian tubes).

I’d like to give you some strategies for optimizing what you can control in your lifestyle – of healthier eating, weight, and activity – to help resolve fertility issues.

Abundant studies show that overweight and obesity clearly promote infertility – and the heavier a woman is, the lower the rates of fertility. A study from this past December in the journal Human Reproduction showed that a woman roughly 50lbs overweight was about 25% less likely to achieve a regular pregnancy (without medical help.) Those with about 100lbs to lose were about 45% less likely to conceive easily.

While we don’t know the reasons for this, it appears that excess weight hampers a woman’s fertility, even when her ovulation is fine, and she has no weight-related health problems (like diabetes or high blood pressure). In addition, those women undergoing fertility treatment, typically need more hormones and adjusted dosing, compared with healthy weight woman. Translation: if you’ve been trying to conceive and have not – check with your doctor, and revisit your lifestyle for the first step in this fertility pathway: healthier eating, weight loss, and a physical activity plan to optimize the factors you can control.


While there is not guarantee that these strategies will work, women following this 10-step plan, based on a number of scientific observations, might have an easier time conceiving:

1. Know your Body Mass Index If it’s over 25, aim to lose 10% of your starting weight (if you’re at 150, that’s 15 pounds). The good news is that just a 10% reduction of starting weight loss can often make the difference in ability to conceive. Click here to find out your Body Mass Index.


2. Discuss your reproductive health with your primary care doctor or obstetrician. You need to rule out a biological basis for your fertility, particularly anatomical blockages, which will not be resolved by dietary and lifestyle changes.


3. Cut way back on processed foods, particularly carbohydrates. Aim for whole grains. When we think of “carbs” many of us don’t think of whole grains. If you consume a lot of processed products – white flour and pasta products, carb/fat/salt combinations (think chips) or carb/fat/sugar combinations (think cookies and cake) – downsize those servings, and up your intake of whole grains. You’re not limited to whole wheat – look for products like couscous, quinoa, flax, and spelt – all of which provide abundant B vitamins, fiber, and plant protein.


4. Increase your intake of fruits and vegetables to at least 5 a day. We often don’t think of fruits and veggies as carbohydrates. These are nature’s perfect food – fiber and water rich, with abundant vitamins and minerals that vary with the color of the food. Fruit is often referred to as “nature’s candy”. Plan a colorful plate.


5. Substitute some plant proteins for animal proteins. Plant proteins, (in contrast to animal proteins – like chicken or beef) are a good way to pack in protein with the added balance of fiber, and multiple vitamins and minerals. Don’t eliminate concentrated lean proteins, but aim to substitute these as a dish in a soup or stew. You’ll feel content on fewer calories, which can help your weight loss effort.


6. Keep a balance of carbohydrates, fats, and proteins. Don’t eat for nutrients alone, and think of the whole food content. Choose real foods – simply prepared and unprocessed as possible. Aim for a balance of ALL the major nutrients – carbohydrates, protein, and heart healthy fat. Balance is key to fueling your body for conception. When certain foods and groups are eliminated, that imbalance might have consequences in nutritional adequacy, which might contribute to fertility. Skip the high protein, low-carb diets, or ultra-low protein diet (say goodbye to juice fasts) – even to lose weight (more on that later).


7. Take a daily vitamin/mineral supplement at least 6 months prior to trying to conceive. A vitamin is good insurance to meet nutritional needs. They’re called supplement for a reason – they ADD to, but do not replace a balanced diet. Choose a supplement of 100% RDI, or a prenatal version. Check with your doctor or pharmacist to optimize your choice.


8. Get 30 minutes of physical activity most days. The metabolic stimulus of exercise goes back to cavewoman days. We were foragers for food, and were forced to be physically active. Activity positively influences brain chemistry, joint and bone function, balance, heart function, hormonal activity, and many other body functions. You don’t have to run a marathon, but aim for 30 minutes of walking each day. Get a pedometer to monitor your steps, with 10,000 daily steps an optimal goal. If you can, mix in some strength training to support muscle tone.


9. Practice stress management. We live in such a stressful world. Learn to address and manage your stressors, to help prevent overeating and weight gain, as well as interference with body hormone secretion, which can be strongly affected by stress.


10. Avoid the quick fix for weight loss. Using the changes above, you should anticipate a weight loss of about ½ to 2lbs a week, depending on your starting weight. You can do this in two ways:
    
    -Count calories from the start: Most women will fall into this rate of loss when consuming anywhere from 1400-1600 calories each day or-
    
    -Multiply your PRESENT weight by 15, to determine calories to maintain your present weight. If you reduce that by 500 calories daily, you’ll lose 1 pound a week; reduce it by 250 calories a day, you’ll lose 2 pounds a month. It’s up to you. (So, if you weigh 150lbs, you’ll need about 2250 calories to maintain. To lose a pound a week, you’ll need roughly 1750 calories). Quick weight loss always fails.

Make the mental adjustment to change your lifestyle for the long term. It’s the perfect time to make this commitment to yourself and your family to lifelong health. A healthy lifestyle is its own reward.

What do you think?

Comments

this is a great article. I read a book you can purchase at www.getfitwithjnl.com and it states the same ideas, but goes into much more depth. I lost close to 29 pounds for my wedding, and I have never felt better thanks to www.getfitwithjnl.com program
I suggest you all check it out.
Nancy
Nurse

i am an obese women and i had no problem
with getting pregant twice. so i believe this obession with obese people is getting out of control. what do you think
that i sit around all day and eat. many of these situations coming to the news is crazy. i know many skinny girls who have problems getting pregant and still to this day have no children.

I find it interesting that the article intro mentions that over and underweight women may have fertility problems, but does not discuss that underweight women should gain weight. I had no issues with fertility, conceived within a month of trying at 34. At conception, I was considered overweight by 10 lbs for my height, and was on a high intensity cardio and weight lifting regimen (2hr/day, 3x/week. My workout routine was based on PT after ACL reconstruction surgery. I do not buy into 'weight chart' recommendations as I am African American, healthy, and my body standards are not in alignment with the general population.

The slant of the article to only discuss the overweight issue in fertility and to ignore the underweight discussion is one of the problems with our perception of weight and health in our society.

I guess discussing both issues was not the point of the article.

I think, just like other posts have mentioned, that weight has absolutely nothing to do with fertility. I know many fat women who have conceived and have many children, so weight is obviously not an issue. I wish they would admit that they just dont know what causes infertility, instead of just throwing out these theories!

I think this article is excellent. There is no question that being obese is bad for a person's health, so why should it be any different when it comes to fertility? Of course, there are always exceptions to this, as I also know many obese women who have gotten pregnant. But I definately see a correlation between the percentage of women who have fertility problems and the percentage of women who are obese. For those of you who don't believe weight has anything to do with fertility, did you read the part about "abundant studies have shown"? These are not just theories. This has been researched. Our country has a serious problem with obesity. And honestly, we SHOULD be obsessed about it because something has to change. If obese people want to get defensive about an article like this, go ahead. But the reality is that unless they make some serious lifestyle changes, they will ultimately destroy their life as well as the lives of those around them.

I think this issue is important & needs to be talked about more. I think the point here is that if you are trying to get pregnant & have not been successful that you might want to see if your weight is a factor.
They're not trying to say that ALL obese women have fertility problems. I've had problems getting pregnant. Adhering to information like this is the only thing that has helped me make progress.We need to be more aware that's all.
How much does it hurt us to cut junk food out of our diet anyway? As a society our eating habits are HORRIBLE. What's wrong w/being healthy? If you feel you're healthy & your body needs to be held to a different standard, that's your prerogative- more power to you. Why waste your energy listening to or reading something that doesn't apply to you?

Point is that it applies to plenty of women that are searching for answers & help- like me. I stopped getting my period & ovulating all together,now since changing my lifestyle I'm doing both again. Not a coincidence. I feel great!

I wish they would not blame weight on infertility I dealt with it for over 10 years and after over $30,000 they came up with unexplained.....unexplained.....I am a size 22wp and a exerciser big walker the Doctors were totally confused with My Husband and I......We Adopted a Wonderful Son He is now 11 but We went thru 10 years of Hell..... unexplained DO NOT USE WEIGHT AND IF YOU DO NOT HAVE INFERTITLTIY WATCH WHAT YOU SAY TO THE COUPLE.....

I know someone who said she could never get pregnant unless she was a certain weight. As soon as she would lose to that weight she was able to get pregnant. I have been trying for 4 yrs. and the doctors find no reason to why I can't conceive. However, I am 5'1'' and 154 lbs and am on the line of overweight and obesity. I am determined to lose at least 20-25 lbs before summer. Hopefully, then I will be able to conceive as this article suggests. Otherwise it's $10,000 for invetro that may or may not work!

i have a cousin whose husband is a chain-smoker, however they have 7 children who are all healthy and intelligent. i have lots of neighbors who smoke, both the husband and his wife smokes but they do have healthy children, how can you say that smoking does effect on fertility? can't you just figure out the reason why some couples don't conceive despite having a balance and health lifestyle? and what about me, i already have a son and after i gave birth to him i did not conceive again...i red a lot of stories, couples who undergone fertility treatments, doctors just let them gave hope but still failed after spending lots of money. did the doctors, too, understand the sufferings all those couples is undergoing after they failed and yet even the doctors don't know the true reason why they don't conceive? money is so hard to earn but many couples still try for the child they are dreaming of.. almost everybody read information from the internet and may we realize the truth behind the articles that were posted...

It appears that there's a misunderstanding about research studies. None of the studies states, "Obese women cannot conceive".They state that of the total number of women who cannot conceive, a higher number of them are overweight than of normal weight. Why is it so hard to take these at face value? Why must we persist in saying that these studies are somehow "wrong" or that they are picking on overwt people? It's time for obese Americans to face the music and admit being overweight has the potential of having some serious consequences.

Articles like this are completely bogus. The numbers it cites for infertility among the obese coincide with the national average. Sandra is right--doctors are clueless about why some women can't conceive. Articles like this just make women feel worse about themselves. (Incidently, my weight was perfect and I was active, healthy, young, etc., and totally, mysteriously infertile for six years.) And what is with that idiotic BMI thing they're ramrodding down our throats as if its some kind of scientific method of measurement? It's still weight-into-height. Bring back the old Metropolitan weight chart posted in the doctor's office that actually made sense! We were all thinner when we followed it, right?

Meghan- Madelyn is not saying that overweight people can't conceive and healthy weighted people can! You have to read. She says that being and unhealthy weight (both over OR under) can contribute to infertility. I'm sure there are 10,000 other things that can contribute, but being an unhealthy weight certainly isn't going to help!

l feel we should settle down with this simple truth that Its God that gives children psalm127v3...lnstead of allowing ourselves to be deceived with science.
When God decide to give children He usually give breaking all natural/scientific laws or else how can science explain a woman that give birth to a set of twins at 60 years of age?

Any one that wants children should ask the Owner/giver of Children[GOD]...He will give us...Without holding back.

Enough of science ...our hope should be on God not science.or how can science explain Sarah in the bible that got pregnant at 9oyears?Lets hold unto God for He alone can and will grant our heart desires{CHILDREN].

If you are still trying to conceive l speak to you now in the name of the Lord, prepare your house for in a years time you will conceive and deliver Twins...any sex you desire in Jesus name....just believe and you will have it.

this is a very much helpful article. But I would like to listen more, how does excess weight work on fertility organs.

Dr. Madely is absolutely right--------"It’s the perfect time to make this commitment to yourself and your family to lifelong health. A healthy lifestyle is its own reward".
Ofcourse if you do not set an example to your offsprings what will you expect from them---an unhealthy life full of diseases? Gosh don't be proud and defend being obese. Save your children's life. They will definately follow your steps.

i like this article...although there are many factors that affect to conceive i observed more obese people had a hard time for it.i'm not having any birth control but after i gave birth to my daughter i'm bigger now...& not conceive although trying for 6yrs already.i also had a friend who is obese & trying to conceive for a year now...so,maybe obesity in some person is a factor...why not try to be live at average wt.after all it's for our own good.

I think there's NOTHING here to connect with PCOS (poly-cystic ovarian syndrom) which is a syndrome linking weight & infertility.

am a dr,and overwt,ve decided to control my wt and not let my wt control me,just to have a healthy life.its not been easy but i just have to get through this.this article is lovely and if its applying to you just make use of it.thanks madelyn.

am a dr,and overwt,ve decided to control my wt and not let my wt control me,just to have a healthy life.its not been easy but i just have to get through this.this article is lovely and if its applying to you just make use of it.thanks madelyn.

The article is very good.Keep the good job up.i've been having serious irregular periods.do you think my excess weight has anything to do with it?pls let me know.

I know deep down that I have to lose weight before I concieve...Regardless if it is true or untrue that obseity hinders your ability to conceive, I only have health to gain by losing. Besides, being obese only makes the later months of pregnancy more uncomfortable! The truth hurts...Off to the treadmill now... Good luck to everyone trying for a baby and trying to be healthier!