You’re a beautiful plus-size woman—and getting pregnant is on the top of your to-do list. Can being overweight reduce your chances of having a baby? Here’s the skinny on sensible, step-by-step strategies to help you prepare and get pregnant.
A good first step is to honestly assess how healthy you are right now. Do you have high blood pressure? Do you have diabetes? Is there a family history of any other diseases? Are you reasonably active? Once you have a handle on your general health, take stock of your fertility. How old are you? Are your menstrual cycles regular? Do you have any diagnosed health issues that might affect your fertility?
The best person to help you interpret all this health information is your doctor. Arrive at your preconception checkup prepared to have an honest discussion about your weight and whether losing weight first before trying to conceive is a good idea. Your doc should be able to suggest a healthy weight range to aim for and, if needed, refer you to a nutritionist for help constructing a sensible and practical preconception weight-loss strategy.
Depending on your health history, your doctor may suggest you undergo testing for type 2 diabetes. Women who enter pregnancy with undetected, untreated high blood sugar levels put their pregnancies at higher risk for birth defects and miscarriage. If results show you do have diabetes, you will need to make sure blood sugar levels are under control before trying to conceive.
Body mass index (BMI) takes center stage during preconception planning because women with a BMI of 30 or higher may be at greater risk for developing gestational diabetes, gestational hypertension, and other health problems during pregnancy. Other studies suggest that, no matter how many points you are above a normal BMI, losing even 10 percent of your body weight before conceiving may dramatically cut your odds for complications.
Crash diets rarely work, and when it comes to pregnancy planning, quick weight loss diets can have negative effects on your health and fertility. If it's in your best interest to lose some weight, look at weight loss not as a punishment, but as one more step closer to a healthy baby. Follow a diet filled with fruits, vegetables, nourishing whole grains, and lean proteins, and take a daily prenatal vitamin, including 400 mcg of folic acid.
Fat enables your body to carry out the staggering number of hormonal changes that must occur each month for ovulation. Too much body fat, however, can upset the body's hormonal balance and disrupt normal ovulation. Irregular ovulation or lack of ovulation are two leading causes of fertility problems among plus-size women. Your doctor may ask you to track your cycles to make sure weight-related factors are not sabotaging your chances.
Pear-shaped women carry most of their excess weight in their thighs and hips. Women who are apple-shaped tend to accumulate excess weight in their mid-section, especially their belly. Visceral (belly) fat can actually produce excess estrogen. Too much estrogen can negatively impact fertility because the powerful hormone may trigger the brain to decrease levels of follicle stimulating hormone (FSH). In turn, lower-than-normal amounts of FSH could mean your eggs do not ripen and mature on schedule.
Not only does it help speed up weight loss, but regular exercise is a natural way to keep your body's hormones in balance. Try adding 30 minutes or more of activity to your daily schedule. Pick activities you actually like—walking, swimming, riding a bike. If you have not exercised regularly in the past, start slowly (walk for 10 or 15 minutes a few times a week). As your stamina improves, gradually increase your workout.
If months of trying have not yet resulted in a pregnancy, it's a good idea to schedule a return trip to the doctor's office. Before your appointment, gather together information about your monthly cycle. Also make a record of any recent illnesses, medical issues, stressful life events, weight gain (or rapid weight loss), or other significant changes in your body. Do the same for your partner. Your doctor may request additional information about changes in cervical mucus over the course of your cycle and changes in basal body temperature to assess ovulation. Depending on what this appointment turns up, you could be referred to a fertility specialist or other health specialist for further evaluation.
If problems with getting pregnant persist, expect your doctor to uncover even more information about your fertility by running blood tests to check hormone levels and performing an X-ray or ultrasound scan to evaluate your reproductive organs. If your difficulty conceiving is likely caused by disrupted ovulation, the most common treatment is—wait for it—weight loss.
But don't be discouraged: the amount of weight loss needed to jumpstart your fertility is surprisingly small. Losing even 5 to 10 percent of your total body weight is often enough to bring your hormones back into balance and restore ovulation.
Some plus-size women who experience missed or irregular ovulation may be prescribed the synthetic fertility drug Clomid. Clomid "tells" the brain to release more FSH and luteinizing hormone (LH), the hormone that triggers the release of the egg. When these hormones increase, ovulation returns. Another alternative is to receive daily hormone injections (a mix of FSH and LH) to balance out elevated estrogen levels and reestablish ovulation. Both methods—Clomid and hormone injections—may stimulate the release of more than one egg, resulting in higher rates of multiple birth pregnancy.
Did further testing turn up that you have something called polycystic ovary syndrome (PCOS)? Approximately half of all diagnosed cases belong to plus-size women. Polycystic ovaries are enlarged ovaries studded with numerous small cysts. Cysts form if the ovary's "dominant follicle" is unable to properly grow and prepare for ovulation due to hormonal interference.
Losing even a small amount of total body weight (again, that magic 5 to 10 percent) is often enough to bring hormone levels back into balance, alleviate symptoms, and restart normal ovulation. Learn more about PCOS and to your doctor about the right treatment for you.
Join our PCOS Suport Group.
It's a drastic measure, but according to at least two studies, weight-loss surgery (also called bariatric or gastric bypass surgery) can jumpstart ovulation in plus-size women whose fertility problems are weight-related. But gastric bypass is not a quick fix. Women who undergo weight-loss surgery are typically advised to wait at least 18 months before trying to conceive. Getting pregnant during the period of rapid weight loss that follows weight-loss surgery may put women and babies at risk for malnutrition. Talk to your doctor.
As an ever-increasing amount of evidence finds, overweight and obese men appear to be at higher risk for sperm production problems and infertility. According to at least one study, obese men— especially those who also have type II diabetes—are more likely than others to have low levels of testosterone, a key component in sperm production. Other research has shown that obese men who lost a significant amount of weight had better sexual function. Your guy ready to diet? Losing weight together can actually be a fun, exciting, and supportive way for each of you to stay motivated for success.
Forget weight for a minute... Could stress, the very thing that might have caused you to overeat in the first place, be a hindrance to your fertility? Powerful emotional distress, like depression, may trigger hormonal imbalances that disrupt ovulation. Feeling calmer, happier, and less stressed could make it easier to become pregnant. To boost your chances of conceiving, try yoga to see if it helps you let go of stress and anxiety. And, of course, share your feelings with your partner.
Read How to Get Pregnant... If You Have Too Much Stress in Your Life.
For plus-size women who struggle with compulsive overeating, following a healthy preconception diet is much more complex than simply planning a nutritious menu and sticking to it. Binge eating is arguably the most common eating disorder in the US today. Most compulsive overeaters binge on food for some kind of emotional relief. Unlike bulimic women, compulsive overeaters do not "purge" themselves after bingeing. If bingeing is your deeply guarded secret, the time has come to break the silence and get help. Talk to your doctor.
Research does indeed show that plus-size women—when looked at as a group—are at higher risk for developing certain complications during pregnancy, including gestational diabetes, gestational hypertension, preeclampsia, and C-section delivery. But what happens during an individual plus-size woman's pregnancy, experts agree, is based largely on her personal health choices and previous medical history. In other words, if you were generally healthy before becoming pregnant, carefully monitor diet and exercise, and actively participate in your prenatal care, the odds are likely in your favor to have a healthy pregnancy.
If your intense desire to have a healthy pregnancy helped you successfully change your eating and exercise habits, stay motivated and be patient. No matter how long it takes to get pregnant, enjoy the process of making a family (or making a family grow). While it might be nice to have a positive result after only a month of trying, that’s almost always the exception, not the rule. No matter what your dress size, take time to relax and enjoy this special time of intimacy between you and your partner.