Being overweight can put your reproductive health at major risk. Here’s how

The silent public health epidemic of the 21st century is obesity. It is a major public health problem in developed countries and India is fast catching up with the rest of the world due to the industrialization and rapid urbanization. In India more than 135 million individuals are affected by obesity.

Are you overweight? Here’s how you can tell
Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health.

To label someone as overweight, we need to define the normal range of weight, which is objectively standardised by body mass index (BMI). BMI is a tool to estimate how healthy or unhealthy you are, and it is calculated by a person’s weight in kilograms divided by the square of height in meters. 

A high BMI is an indicator of high body fatness. 

• Women with a BMI of 25 to 29.9 are considered overweight.
• Women with a BMI of 30 or more have obesity.

Another standard can be used to measure fat is waist circumference. If a woman’s waist circumference is larger than 35 inches then she is considered overweight. 

Excess fat distribution in the central part of the body—i.e tummy, hips, and chest—increases the risk of insulin resistance and releases excess oestrogen which can trigger hormonal imbalance. These changes are major contributors in development of acquired polycystic ovarian syndrome (PCOS).

This excess weight can also impact a woman’s reproductive health
The reproductive health of a woman includes her menstruation, fertility and pregnancy related health. Excess weight can impact all of these aspects of her life. Here’s how:

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1. Menstrual health
Hormonal imbalance is a cause of irregular periods, PMS, and heavy prolonged periods. It can lead to anaemia, psychological or mood disorders, and body image issues due to body shape, excess body hair. All of these things are also commonly present in PCOS.

2. Fertility
Some women with High BMI can require medical treatment to conceive as they can suffer from subfertility and take longer to conceive spontaneously. Normally, this is due to infrequent ovulation. Polycystic ovarian syndrome is associated with anovulation (non production of egg). The fertility treatment results are poor in overweight women as compared to normal BMI women.

3. Pregnancy
Overweight and obesity can put an otherwise healthy woman at a higher risk to develop gestational diabetes, blood pressure or pre-eclampsia. It has been shown to increase risk of miscarriage, preterm delivery, growth restriction in babies, and Caesarean section deliveries. High BMI increases anaesthetic risks, risk of blood clot formation in pregnancy, and post delivery.

Preconception care and counselling is very important in women with high BMI and stress should be given to identify underlying hidden medical conditions, treat them, and optimise mothers’ health. This helps to lower medical interventions in pregnancy and gives the woman the maximum chance for natural childbirth.