Weight Management and Wegovy

Weight management is a lifelong challenge for many people, and it can be especially daunting for those trying to conceive.

If you're looking to start your pregnancy journey, you'll likely want to do as much as you can to prepare your body and improve your fertility. Well, we are here to help!

Below, Dr. Kathryn Calhoun and Dr. Angelina Cain break down weight, pregnancy, and pre-pregnancy to support you on your path to parenthood.

How Obesity Affects Fertility

Almost 70 percent (69%) of American adults struggle with elevated body weight, and 40% of American adults have obesity. Fat (adipose) is an active organ and can affect hormone levels and inflammation in our body, so it is not surprising that obesity reduces fertility and elevates pregnancy risks for both mom and baby. These elevated risks include miscarriage, birth defects, high blood pressure, diabetes, fetal growth problems, and preterm delivery.

As fertility specialists, we have the opportunity and privilege to guide our patients through pre-pregnancy weight loss and health optimization, which can boost pregnancy rates and pregnancy health. Our primary goal is to help our patients achieve their dream of having a healthy baby, and sometimes, weight loss is crucial in improving fertility rates.

Weight Loss

Weight loss is not easy, especially as an adult. With each advancing year, our body composition and calorie-burning ability change, so we need to eat less and move more to stay the same size.

Caloric deficit/dieting (eating less energy than you expend) causes weight loss, and exercise maintains weight loss. Exercise also improves insulin sensitivity, heart/lung health, and muscle mass/metabolism. Adherence to a weight loss plan is the best predictor of success, so picking a plan that will work for the rest of your life (with modification during pregnancy) is essential.

For patients with obesity (BMI >30) and/or associated medical problems (diabetes, heart disease), a more aggressive intervention may be necessary. Medically-monitored weight loss via meal replacements, medications and/or weight loss surgery may be considered if other efforts have failed.

Weight Loss Medications

The first-line anti-obesity medication for many patients will be a glucagon-like peptide 1 (GLP-1) agonist, like Semaglutide (Wegovy or Ozempic). These medications are weekly injections that stimulate insulin secretion (which helps the body's cells to utilize glucose/sugar from the foods we eat). They also delay gastric (stomach) emptying — making you feel more full so that you will eat less.

These medicines were originally intended for (and still used by) diabetic patients to improve blood sugar control and weight loss. The doses are typically increased at four-week intervals, and side effects (nausea, vomiting) should be monitored by an experienced weight loss health care provider – we refer our patients to Dr. Angelina Cain at Excelsis Health.

Patients should stop Semaglutide two months prior to conceiving – discontinuing/tapering the medicine should also be monitored by an experienced provider.

If Semaglutide is unsuccessful or not tolerated, or if patients have a contraindication to Semaglutide, other weight loss medicines include Orlistat, Qsymia (Phentermine/Topiramate), or Contrave (Bupropion/Naltrexone).

Experience Personalized Care at ACRM

Remember, weight management is a multifaceted journey, and while medications like Wegovy or Ozempic can be helpful, they should be considered as part of a comprehensive approach that includes lifestyle modifications such as a healthy diet, regular exercise, stress management, and adequate sleep.

Consulting with healthcare professionals specializing in fertility and weight management can provide personalized guidance and support. If you're interested in exploring your options and preparing for pregnancy, contact us today.

You don't have to navigate this path alone – we're here to support you every step of the way.