Obesity is a major public health concern worldwide and affects different people in various ways. This includes couples who are looking to get pregnant, as recent studies have highlighted the impact that obesity has on fertility. Regardless of the mode of conception, obese women show poorer reproductive outcomes compared to women with lower BMI. In fact, according to the American Society for Reproductive Medicine (ASRM), obesity is the cause of fertility struggles in 6% of women who have never experienced pregnancy before. Obese men also face similar challenges when it comes to fertility, as they are more likely to have very low or even nonexistent sperm counts.
As such, many obese individuals who are looking to conceive typically aim to lose weight first. However, since losing weight can be a nuanced and often complicated process, some people require more advanced interventions such as medical weight loss.
What is medical weight loss?
What sets this apart from more traditional weight loss methods such as exercising and dieting is the presence of doctor-prescribed medications. With medical weight loss, these off-label prescription medications address biology-based weight loss barriers and help even out the playing field for patients. These medications typically work by suppressing appetites and inhibiting fat absorption.
However, it is important to remember that medication alone cannot teach a healthy lifestyle, which is still the foundation of any weight loss venture. This is why programs also put heavy emphasis on behavioral therapy and lifestyle changes. Through cognitive-behavioral therapy, motivational interviewing, and mindfulness-based interventions, patients will be able to better identify and change their unhealthy habits that contribute to weight gain. These will allow lifestyle changes in the form of adopting a healthy diet, increasing physical activity, and getting enough proper sleep.
It must be said though, that while medical weight loss may seem enticing to many individuals looking to lose weight, especially couples who wish to better their chances of conceiving, the program is not fit for everyone. This therapy is approved only for individuals who meet certain medical requirements and fall under a specific BMI category of at least 30 or close to it with comorbidity.
Medical weight loss benefits for improving fertility
These programs can provide a safe, effective, and comprehensive approach not only to weight loss, but also to fertility in both females and males.
In women, obesity changes the way the body stores sex hormones. Fat cells convert androstenedione (a male hormone) into estrone (a female hormone), which then affects part of the brain that regulates ovarian function. This can, in turn, impair reproductive function. Effectively losing weight through medical weight loss programs will improve these hormonal imbalances, as well as egg quality. In addition, losing excess weight can also greatly reduce the risk of any complications during pregnancy.
Just like women, obesity also causes hormonal imbalances in men. They are more likely to have higher estrogen levels on top of lesser sperm-producing hormones like inhibin B and androgen. Additionally, obesity often elevates body temperatures, especially around the scrotum, which drastically affects sperm quality. Medical weight loss can help by managing any extra pounds, thereby improving testosterone levels, as well as sperm count, concentration, and motility. On top of this, it will reduce the risk of erectile dysfunction.
Pregnancy considerations in medical weight loss
While living at a healthy weight can help with fertility and maintaining a smooth pregnancy, medical professionals strongly advise against attempting to conceive while taking any weight loss medications or procedures. This is because as much as the interventions encourage weight loss and restore hormones, their full effects on active pregnancy have not yet been explored by experts.
While medical weight loss is by no means harmful to individuals, it is important to always consult with doctors regarding its effects on pregnancy. In the case of medications, most medical professionals advise waiting at least two months after discontinuing weight loss medications (with doctor’s supervision) before attempting to conceive. Even weight loss procedures such as bariatric surgery, which greatly help women have safer pregnancies through the same effects of nonsurgical medical weight loss, typically require waiting 18 to 24 months post-surgery before attempting to conceive.