Recomendations for overweight women who want to conceive.

[Carol]

Although body weight should not be a factor in trying to conceive, some concerns may arise for women who are obese or too much overweight (as well as for women who are too much underweight).

Overweight or obese women are at a high risk of developing gestational diabetes, high blood pressure and venous thrombosis during pregnancy, as well as having labour complications during the delivery of the baby, so that caesarean section is performed in many cases. Overweight and obesity may be a problem even before getting pregnant: overweight women may not be able to conceive as a consequence of hormonal imbalances that prevent ovulation to occur regularly.
That’s why many healthcare providers advise overweight women who want to get pregnant to lose their extra weight before conceiving. However weight loss should be a gradual process. Losing too much weight in too a short period of time can cause damage to key organs (such as kidneys and liver) and lead to an increased risk for pregnancy toxaemia.

The weight loss diet should be planned in consultation with a physician and a dietitian and should be supported with an adequate exercise program.

Diet should be rich in vegetables, fruit, whole grains and beans, which are all sources of carbohydrates having a low to moderate glycemic index. Refined, high-glycemic index carbohydrates such as white flour, white rice, white potatoes and sugar-sweetened foods and beverages should be avoided. These foods provide energy, but have less nutritional value and fiber content than vegetables, beans and whole grains. Saturated fats (present in meat, dairy products, sweets and pastries) should be minimized, while essential fatty acids such as omega-3 fatty acids (present in oily fish, walnuts, pumpkin seeds and flax seeds) should be maximised.

Daily food intake should be divided into small, frequent meals and snacks, and breakfast should never be skipped. Each meal or snack should contain high-quality protein. In fact regular protein consumption is important in maintaining blood glucose and insulin levels and minimizing appetite; moreover it helps the body maintain lean body mass during weight loss.

In general, extremely overweight women tend to be less active. Regular exercise is the most natural way to improve fertility: it can help lose weight, reduce stress and improve sleep. All these factors, in turn, affect positively fertility. Exercise should not be too vigorous: in fact, intense physical activity lowers estrogen levels, thereby compromising fertility. 30-45 minutes of moderate exercise per day (walking, swimming or bicycling) is the recommended time for women who want lose weight, improve fertility and get pregnant. Moderate exercise is also helpful during pregnancy: not only it can improve the overall health of pregnant women (both normal and overweight women), but it can also help reduce the risk of deep venous thrombosis in overweight women.

Losing weight gradually through a healthy, balanced diet and regular exercise may appear very difficult or impossible for many women, if they are not enough motivated. However the desire of having a baby is a strong motivation for changing lifestyle and food habits: with the dream of getting pregnant and giving birth to a baby, reasons for losing weight will become second nature.