Obesity and infertility often go hand in hand. Obesity reduces fertility, and it is well known that a high Body Mass Index (BMI) lowers pregnancy rates in in vitro fertilization (IVF)..
This is why many fertility specialists refuse to begin treatment for obese women until their BMI returns to normal levels. Naturally, this advice is for their own benefit, since what doctors truly want is for their patients to achieve pregnancy. However, the issue is far more complex than it appears at first glance.
No one wants to be obese, and most women who are overweight have already tried everything to lose weight and regain their figure — after all, overweight people don’t need a doctor to tell them they should lose weight; they already know it. But (as most of us can confirm from personal experience), losing weight is extremely difficult.
For many of us, every time we lose one kilogram, we end up gaining back two. This is, of course, very discouraging, and hearing others point out that you are overweight can make you feel not only hurt but also offended.
The problem becomes even greater if you are also infertile. Many people will tell you that your obesity is the reason you are not getting pregnant — and that makes you feel even worse about yourself. Not only can you not lose weight, but you also cannot have a baby! Moreover, some doctors may even be rude and refuse to take on women with infertility until they manage to bring their BMI back to ideal levels.
This is certainly unfair and harsh. No overweight woman wants to be overweight. Many have tried everything possible to lose weight, but simply haven’t succeeded. It’s a common tendency for some to accuse them of lacking willpower, but this only makes matters worse because it adds guilt. When a doctor refuses to treat them because of obesity, they feel trapped and hopeless — and this can often lead to gaining even more weight. They no longer feel like going out or exercising, and out of self-pity, they stay home and eat more, without knowing how to break the cycle. Infertility and the inability to lose weight further lower their self-esteem and lead to a vicious circle.
Doctors need to learn to be kinder to women who are obese. Suggesting that they “just lose weight” is easy, but if the woman insists that she has already tried and failed — or if she follows a program of her own and still doesn’t succeed — doctors should not refuse to treat her. By discouraging her, they make the situation worse, because she will spend precious time trying to lose weight instead of trying to conceive, and that is valuable time that cannot be recovered.
How should we approach overweight women?
Specific solutions are needed — with a well-structured weight loss plan, where fertility specialists help them follow it in collaboration with dietitians, physiotherapists, and fitness trainers. They must also show compassion and appreciate that these women have done everything possible to lose weight, regardless of whether they have succeeded or not.
There is no reason to refuse treatment to them, regardless of what certain guidelines might say. Instead of focusing on BMI, it would be far better to focus on the patient herself.
