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Obesity biggest challenge to getting pregnant, say doctors

Dubai: Doctors from Dubai Health Authority (DHA) discussed women’s health issues to mark International Women’s Day and marked obesity as the biggest challenge to women in childbearing age.

Dr Muna Tahlak, CEO of Latifa Hospital, said: “Advances in gynaecological field including laparoscopy and fertility treatments have presented various advanced treatment options that were not available previously. However, the high prevalence of obesity has been the biggest challenge to women’s health. Obesity really affects a woman’s health in many ways: it can cause fertility issues and complications during pregnancy and childbirth. Despite advances in fertility treatments, sadly rising obesity rates around the world have had a negative impact on female reproductive health.”

The hospital sees a high number of patients who are overweight or obese at the time they come for pre-pregnancy counselling.

Dr Amal Al Qedrah, consultant gynaecologist and infertility specialist at Latifa Hospital, seconded that: “It is not uncommon to see patients who weigh 80 to 90 kilos before their pregnancy; we even have patients who weigh more than 100 kilos and approach us for fertility counselling. If a woman’s BMI is 35 or above, we do not offer any fertility options because there are many risks associated with pregnancy when the mother is obese. Therefore, the first thing we do is device a comprehensive lifestyle modification plan for her that includes consumption of healthy food and regular exercise. In many cases, weight loss itself can solve several fertility problems such as irregular periods etc and helps boost fertility as it regulates the hormones in the body. Women’s bodies need to be at an appropriate weight to produce the right amount of hormones and regulate ovulation and menstruation.”

Al Qedrah added that women who have polycystic ovaries are at a higher risk of putting on weight and they need to take extra care to ensure they do not pile on the pounds. “In the case of polycystic ovaries, it is a vicious cycle, the disease causes weight gain and weight gain can cause the disease. Therefore, for such patients, we recommend going on a diet, which is low in processed foods and sugars and we recommend weight training at least three times a week to help regulate the hormones and ovaries. It is a known fact that weight reduction enhances reproductive outcomes.”

She added that according to several international studies, women who are overweight or obese have less chance of getting pregnant overall. “They are also more likely than women of healthy weight to take more than a year to get pregnant. Those who get pregnant need to follow their antenatal plan carefully to prevent complications during pregnancy and childbirth. We advise them to eat healthy foods during pregnancy and limit their weight gain to only 12 to 15 kilos during pregnancy. This is because the risk of overweight and obese women developing gestational (pregnancy-related) diabetes is much higher than women who have a healthy weight. The risk of pre-eclampsia also increases in overweight and obese women.”

She added that obesity increases the chances of having a C-section delivery by 20 per cent.

She said that obesity can also aggravate symptoms of pelvic organ prolapse, stress urinary incontinence and increase the risk of endometrial polyps and symptomatic fibroids. Obesity is also linked to a higher chance of developing several diseases such as diabetes, high blood pressure, heart disease etc.

Dr Waffa Ayesh, director of Nutrition at the DHA, said: “A BMI between 25 and 29.9 is considered ‘overweight’ and a BMI over 30 is considered ‘obese’. Ideally, women should aim to achieve a BMI in the range of 19 to 24. Weight loss is linked to lifestyle and daily habits and while nutritionists and doctors can provide all the right knowledge and information, at the end of the day, it boils down to whether the patient is ready to make the changes needed to achieve the desired results.”

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