A Review of the Impact of Obesity on Reproduction and Potential Barriers In Conveying the Message

Stephanie Welsh, Leah D. Whigham, Rose Maxwell, Steven R. Lindheim*

A Review of the Impact of Obesity on Reproduction and Potential Barriers In Conveying the Message

For centuries the adage “Knowledge is Power” has assured
us that the accumulation of knowledge is the key to having more options,
influence, and success.

As physicians, we take pride and comfort in the fact that our knowledge
and training will equip us with the necessary power to heal our patients.
However, what we are learning is that knowledge simply may not be enough.

It has become increasingly clear that the manner in which we relay
our knowledge is just as important. This concept especially applies to
areas of health care that are particularly sensitive and emotionally charged,
including obesity and reproduction.

The evidence is overwhelming that we are facing an obesity epidemic
that has serious health consequences. Moreover, from a reproductive
health standpoint, the consequences include reduced menstrual function,
fertility, success rates utilizing Assisted Reproductive Technology, and lower live birth rates.

To handle obesity and promote fertility, the American Society
for Reproductive Medicine advocates that physicians need to counsel
their obese infertile patients about the harms of excess weight on reproduction,
and advise them on dietary modification, physical activity, and weight loss.

To manage overweight and obesity in the primary care setting,
the American College of Cardiology, the American Heart Association
Task Force on Practice Guidelines, and the Obesity Society recommend
shaping recommendations on diet, lifestyle intervention, and bariatric
surgery around each individual patient’s preferences and risk factors.

This requires a complex, individualized approach for which most
physicians have not been trained.

In addition, a significant barrier to addressing obesity
is physician and medical staff bias—whether conscious
or not—against people affected by obesity.

Gynecol Obstet Res Open J. 2016; SE(3): S1-S7. doi: 10.17140/GOROJ-SE-3-101