Obese Britain Summer 2015.pdf

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A magazine about Healthy Living, Weight Loss, Exercise and Dieting. Distributed with the Guardian on the 27th June 2015 www.obesebritain.com

observed to detrimentally effect endometrial development

– the development of the womb lining - and implantation

of the embryo, thereby also leading to an increased risk

of miscarriage.

The commonest hormonal problem experienced by

women is polycystic ovary syndrome (PCOS), an area

that has been the main focus of my research over

the years. The expression of PCOS is regulated, in

part, by weight and so obese women with PCOS

often have more severe symptoms and experience

more sub-fertility.

Obesity also impairs the response of women to

all fertility treatments, which is why the National

Institute of Care Excellence (NICE) advises

that NHS funding for fertility treatment

should not be offered to women with

a BMI of more than 30. Weight

loss through lifestyle modification

or bariatric surgery has been

demonstrated to restore menstrual

regularity, ovulation and improve

the likelihood of conception and a

healthy pregnancy, both naturally and

with treatment.

CASE STUDY

Lucy (not her real name) attended our

clinic eighteen months ago at the age

of 29 and with a BMI of 36, she had

irregular periods but otherwise she and her

husband were healthy. Since puberty she

had struggled with her weight and found

it difficult to exercise. When we explained

the impact this was having on her fertility

she enrolled in a weight management

programme, was careful with her diet

and started to swim and then started

running once her weight started to fall.

She came back to clinic after 6 months

with a BMI of 32, by which time she

didn’t need further encouragement as she

was enjoying feeling fitter. After a further

three months her periods were regular and

she conceived naturally without the need

for treatment.

FACTFILE:

BODY WEIGHT AND FERTILITY

• Fertility is most likely in people with a

normal weight

• Women who are underweight stop having periods

• Women who are overweight and obese have a 2-3

fold reduction in their fertility

• Being overweight increases risks during pregnancy and

also may adversely effect the long term health of children

• Fertility treatments are less likely to work in people who

are overweight

• Weight loss is best achieved by a combination of diet

and exercise

ABOUT THE AUTHOR

ADAM BALEN

Professor Adam Balen MB, BS, MD,

DSc, FRCOG is a full time Consultant in

Reproductive Medicine at Leeds Teaching

Hospitals NHS Trust.

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