HCA Midwest Health - January 10, 2024

There are many factors to consider when deciding whether weight loss surgery is right for you, not the least of which are “will I still be able to give birth and how will caring for a baby fit into my new lifestyle?” The success of weight loss surgery requires a total commitment to lifestyle changes, so be honest with yourself as you make your decision.

If you want to become pregnant in the near future, you may be wondering how having a baby fits into the timeline of weight loss surgery. We asked Dr. Nicole Fearing, MD, a board-certified bariatric and general surgeon at Bariatric and Metabolic Specialists – a part of HCA Midwest Health - to explain the link between fertility and obesity as well as her recommendations on when it’s safest to start trying to have a baby.

How does obesity affect fertility?

Dr. Fearing suggests before you start trying to have a baby, that you have a candid conversation with your primary care doctor about your overall health and how this may affect your ability to conceive and care for a baby. Multiple factors can affect fertility, including age, weight and preexisting medical conditions. “When you're overweight, your estrogen balance can affect the way that you get pregnant, so being morbidly obese may decrease your fertility.” Dr. Fearing says. “When women lose a significant amount of weight, they generally become more fertile.”

When is a healthy time to get pregnant?

While significant weight loss can increase a woman’s fertility, doctors advise it’s best to wait at least a year to a year and a half after bariatric surgery before becoming pregnant. Dr. Fearing cautions, “the weight loss and metabolic aspects of surgery really are within the first one to two years, with the bulk of it being in the first year. Our goal is to help get you healthier and potentially more fertile, but not for you to have a baby for at least the first 12-18-plus months after your weight loss surgery.”

You’re likely to experience significant lifestyle changes during your recovery from surgery, so it’s important to focus on healing and reaching your desired weight. These changes will help you lose weight and improve your overall health, making you better prepared to carry a baby. “Your nutrition may not be exactly where it needs to be in the early phases after surgery,” Dr. Fearing says. “You need time to focus on getting enough protein, fluids and vitamins right after surgery. Also, we want to capture those prime metabolic effects while you're losing the weight but before you get pregnant.”

Surgery recovery and a healthy pregnancy

The American Society for Metabolic and Bariatric Surgery (ASMBS), says there are two main reasons why it’s important to wait until your body is fully recovered from weight loss surgery before getting pregnant. First, women who wait to conceive are less likely to experience complications during pregnancy and childbirth. Second, the children who are born after weight loss surgery are at lower risk of developing obesity later in life, which research suggests is due to certain genes being activated during fetal growth.

Dr. Fearing offers this advice for women regarding pregnancy and weight loss surgery.

Before pregnancy

Ask your doctor (obstetrician/ weight loss surgeon)

  • If you’re considering weight loss surgery but have questions about how it might affect fertility and pregnancy in the future, it is important to share these concerns with your obstetrician and weight loss surgeon. The doctors will take the time to provide you with guidance based on your individual needs and circumstances. They can also walk you through what to expect before and after surgery. Find a weight loss surgeon near you.
  • IF you do become pregnant after weight loss surgery it is important to follow up with your bariatric surgeon if it is before a year after surgery. Close follow up is needed for a successful pregnancy

During pregnancy

Take a multivitamin

  • Whether it’s a prenatal vitamin or a bariatric-strength vitamin, be sure to take a multivitamin with iron daily. Your doctor can recommend a vitamin based on your individual needs during pregnancy.

Maintain proper nutrition

  • Be sure to eat a healthy, balanced diet containing a wide variety of foods with a minimum of 1,800 calories a day. Your baby’s healthy growth is the top priority, not losing weight.
  • IF you had weight loss surgery and experience severe pain, nausea, vomiting or reflux it is important to inform your bariatric surgeon.

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