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Overweight and Trying to Conceive
Author: Dr. Anna Kaplan
If you have decided that you want to have a baby and you are overweight, there are some things you need to do and things you need to think about before you try to get pregnant.
While it is harder to conceive when you are overweight, it is far from impossible. But there are risks for you and your baby if you are pregnant and significantly overweight, especially if this is your first baby. You are more likely to develop a condition called preeclampsia, which is risky for both of you. You also have a greater chance of developing diabetes during pregnancy, high blood pressure, blood clots, and you are more likely to have trouble with labor and delivery including severe bleeding afterwards.
Your baby is more likely to be born with a congenital anomaly if you are very overweight than if you are not. This includes heart problems, neural tube defects, and facial clefts, as well as multiple abnormalities together.
There is also a higher risk of miscarriage, preterm birth, and stillbirth for obese women. For example, obese women have four times the risk of giving birth to a stillborn infant than women of normal weight. If a baby is born preterm and small, future development may be delayed and abnormal. Obese women are more likely to have very large infants (called macrosomia) which can present a danger during delivery, both to the baby and the mother.
It is also true that very overweight women have more trouble getting pregnant. Some of them have polycystic ovary syndrome (PCOS – see article on this topic). Some do not. Fat cells metabolize hormones, and an excess amount of fat can alter metabolism enough to interrupt the normal ovulatory cycle.
The dangers of being overweight come into play when a woman’s BMI is above 35 Kg/m2, which is defined as morbid obesity. Although some would say a BMI above 30 Kg/m2 (obese) is still dangerous. To calculate your BMI, you measure your height in inches and then square that number (your height in inches times your height in inches). Weigh yourself. Divide your weight by the number that is your height squared. To convert this number into Kg/m2 you multiply the total by 703.
Women are considered underweight when they have a BMI less than 20 Kg/m2. A BMI of 20 – 24.9 Kg/m2 is normal. Overweight women have BMIs of 25 – 29.9 Kg/m2. And obesity is defined as a BMI of 30 – 34.9 Kg/m2, while morbidly obese is a BMI greater than 35 Kg/m2.
Obese women who are not ovulating may start to ovulate after losing as little as 5% of their body weight, perhaps as little as 2%, though they will not have lost enough weight to avoid all the other risks and complications. Practically speaking, this means that you may want to try and lose significant weight before trying to get pregnant. This is a chance for you to get healthy and ensure the health of your baby. Once you get pregnant, you cannot diet. You have to eat enough for the baby.
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