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Home » Exercise Programs » Infertility? Take the Weight off your Chest – Times of India

Dr. Sukhvinder S Saggu, MS FACS(USA), Director, Minimal Access and Bariatric Surgery, Apollo Spectra hospital, Karol Bagh, New Delhi, India

An everyday instrument may help steer many couples struggling with infertility in the right direction, rather than any popular advice - the weighing scale! That is correct. Obesity could be the real reason for many couples infertility problems. In both men and women, obesity severely damages fertility1-2 .

In women, obesity may cause irregular menstrual cycles3, PCOS (Poly-Cystic Ovarian Syndrome), or the way a womans body stores sex hormones. Any of these three conditions may cause infertility4. To make it worse, many women with obesity may be suffering from more than one of these conditions together.

If a woman with obesity tries to conceive without resolving the weight issue, she may expose herself and the baby to three more pregnancy risks caused by obesity: miscarriage5, gestational diabetes6 and gestational blood pressure7. Thats not all. The increased risk of birth defects such as congenital heart disease and host of other serious anomalies in the babies are linked to the mothers obesity8.

In men, a review of 14 studies found that 51% of men with obesity are more likely to have either no or very low sperms in their ejaculate9.

Is there a dependable and lasting escape from the obesity trap? Yes, and understanding obesity could be the first important step.

DEFINING OBESITY:

Obesity is not defined by your weight alone. It is calculated by a unit called the Body Mass Index (BMI), that measures your weight in relation to your height to determine obesity and its severity.

World Health Organization (WHO) considers a BMI more than 30 as Class 1 obesity10. BMI above 35 is Class II i.e., serious obesity, and BMI above 40 is Class III i.e., severe obesity11.

Obesity is not a cosmetic condition. Its a complex, chronic disease that requires medical attention as declared by the American Medical Association (AMA) in 2013, as a result of three decades of research and developments12.

HOW TO TREAT OBESITY?

Will dieting work?

The restrictive diets dont reduce obesity13 and majority of the people who diet regain the lost weight plus more14 according to several research findings.

What about exercise?

A review of several studies reported that clinically significant weight loss is unlikely to occur. Exercise programs actually play a role in weight regain after initial weight loss. Overall, aerobic exercise programs consistent with public health recommendations may promote up to modest weight loss (~2 kg)15.

Then what is the solution?

If you have tried lifestyle modifications, diet, exercise etc., and not losing much weight or unable to keep off the lost weight for a long time, consulting a qualified obesity expert might be an option for you. Minimally invasive

bariatric weight-loss surgery might be an option if your BMI is above 32.5 with type 2 Diabetes or any other obesity related co-morbidity; or if your BMI is more than 37.5 without any co-morbidity16.

A review of 18 studies published in April 2020 reported that bariatric surgery significantly improved hormonal balance and sexual functions in both males and females, sperm count in males, and pregnancy in females17.

Another study revealed that 62.72% infertile women with obesity succeeded in conceiving after bariatric surgery18.

Nowadays due to COVID 19, many Doctors offer online consultations. One could book an appointment at a center of ones choice, and discuss the obesity issues with the expert doctor from the convenience of ones home.

Dont be a victim of obesity or its stigma. Obesity induced infertility can be treated with lasting results. The time to act against it is NOW!

Disclaimer: This article is sponsored by J&J in public interest. The views and opinions expressed in the article by participating doctors are based on their independent professional judgement. J&J (P) Ltd., BCCL and its group publications disclaim any liability for the accuracy or consequences flowing from adherence to their expert views.

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1. Dag ZO, Dilbaz B. Impact of obesity on infertility in women. J Turk Ger Gynecol Assoc. 2015; 16(2): 111-117.

2. Palmer NO, Bakos HW, Fullston T, Lane M. Impact of obesity on male fertility, sperm function and molecular composition. Spermatogenesis. 2012; 2(4): 253-263.

3. https://www.nejm.org/doi/full/10.1056/NEJM195207102470204

4. Silvestris E, de Pergola G, Rosania R, Loverro G. Obesity as a disruptor of female fertility. Reprod Biol Endocrinol. 2018;16(1):22. Published 2018 Mar 9. doi:10.1186/s12958-018-0336-z

5. H. Lashen, K. Fear, D.W. Sturdee, Obesity is associated with increased risk of first trimester and recurrent miscarriage: matched casecontrol study, Human Reproduction, Volume 19, Issue 7, July 2004, Pages 16441646, https://doi.org/10.1093/humrep/deh277

6. Susan Y. Chu et.al., Maternal Obesity and Risk of Gestational Diabetes Mellitus, Diabetes Care Aug 2007, 30 (8) 2070 2076; DOI: 10.2337/dc06-2559a

7. Juliette Madan, Minghua Chen, Elizabeth Goodman, Jonathan Davis, Walter Allan & Olaf Dammann (2010) Maternal obesity, gestational hypertension, and preterm delivery, The Journal of Maternal-Fetal & Neonatal Medicine, 23:1, 82-88, DOI: 10.3109/14767050903258738

8. https://pediatrics.aappublications.org/content/pediatrics/111/Supplement_1/1152.full.pdf

9. Sermondade N, Faure C, Fezeu L, Lvy R, Czernichow S, Obesity-Fertility Collaborative Group AT. Obesity and Increased Risk for Oligozoospermia and Azoospermia. Arch Intern Med. 2012;172(5):440442. doi:10.1001/archinternmed.2011.1382

10. https://www.who.int/health-topics/obesity#tab=tab_1

11. https://asmbs.org/patients/disease-of-obesity

12. Kyle TK, Dhurandhar EJ, Allison DB. Regarding Obesity as a Disease: Evolving Policies and Their Implications. Endocrinol Metab Clin North Am. 2016;45(3):511-520. doi:10.1016/j.ecl.2016.04.004

13. Mann T, Tomiyama AJ, Ward A. Promoting Public Health in the Context of the "Obesity Epidemic": False Starts and Promising New Directions. Perspect Psychol Sci. 2015;10(6):706-710. doi:10.1177/1745691615586401

14. https://newsroom.ucla.edu/releases/Dieting-Does-Not-Work-UCLA-Researchers-7832

15. Swift DL, Johannsen NM, Lavie CJ, Earnest CP, Church TS. The role of exercise and physical activity in weight loss and maintenance. Prog Cardiovasc Dis. 2014;56(4):441-447. doi:10.1016/j.pcad.2013.09.012

16. https://www.theossi.com/guidelines-obesity-surgery.html

17. Moxthe LC, Sauls R, Ruiz M, Stern M, Gonzalvo J, Gray HL. Effects of Bariatric Surgeries on Male and Female Fertility: A Systematic Review. J Reprod Infertil. 2020;21(2):71-86.

18. Musella M, Milone M, Bellini M, Fernandez LM, Leongito M, Milone F. Effect of bariatric surgery on obesity-related infertility. Surg Obes Dis. 2012; 8(4): 445-449

Disclaimer: Content Produced by Dr. Saggu

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Infertility? Take the Weight off your Chest - Times of India

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Home » Exercise Programs » Infertility? Take the Weight off your Chest – Times of India