Weight + Fertility: How much does BMI matter?
Let’s talk about weight and fertility.
There’s been a bit of a social media storm this week after the NYTimes published a piece on fertility clinics who refuse to work with women over a specific BMI (read “When You’re Told You’re too Fat to Get Pregant” here).
Obviously this had the TTC community up in arms and many women shared their stories of being turned away from fertility clinics.
It’s taken me a few days to decide what I want to say about this topic, but here are a few thoughts:
My overall view is that women shouldn’t be reduced to numbers and refusing to work with women for whatever reason (without helping them resolve that issue or reason) doesn’t feel right to me. But neither does taking tens of thousands of dollars from couples when you know there’s very little chance of success.
I think what these clinics are missing is a deeper understanding of the nuances of fertility and womens’ health. Women aren’t numbers, and without looking at an individual’s fertility holistically, we aren’t serving women and couples in the way we should.
Which I guess is why I’m here and do what I do in the first place.
So let’s look at how I address weight and fertility in my coaching practice.
First of all, I want to highlight 2 important things:
1. Studies do link high BMI to lower fertility rates, meaning that weight can play a role in fertility. However, many women with high BMIs get pregnant all the time with no trouble, meaning that weight itself is not the only determining factor.
2. Fertility is a SYMPTOM of your overall health. Your reproductive system doesn’t exist in isolation, and your menstrual cycle and fertility are simply reflections of what’s happening in your health overall.
My view is that while weight can be a factor, it’s rarely the only factor influencing fertility, and in some cases BMI can actually be a symptom of the same imbalance that’s affecting fertility. And if we work to help women balance their hormones and improve their overall health, we can positively influence fertility. Sometimes weight loss also happens, but I’m rarely concerned with weight loss in and of itself.
When I work with women, I start by looking at her overall hormonal health and menstrual cycles. Rarely does a woman struggling to get pregnant have a healthy menstrual cycle–usually cycles are irregular, too short, too long, too light, too heavy. All of these things are signs of hormone imbalance and this hormone imbalance is a symptom of a larger health imbalance, and THIS IS WHAT’S CAUSING THE FERTILITY PROBLEM.
I see my job as helping women find this root cause and work to restore balance in their bodies as a whole.
Weight can be a contributor to hormone imbalance, but we also don’t gain weight in isolation, so understanding what’s happening with a client’s weight (instead of just telling them to lose weight) is very important.
Sometimes diet can be an issue and I always work to make sure women are getting all the nutrients they need to support their hormones–although women who come to me are often already eating pretty well. We might make a few changes and add in more veggies; and we may look at HOW they are eating (not just what), because the way we eat influences how our bodies use that fuel.
The thing is, however, that sometimes the way a woman eats (plus her exercise habits), just don’t add up to what her BMI is saying. And a lot of women have experienced this, right? You feel you’re eating really well, you exercise every day, but you just can’t seem to lose any of that weight.
Usually there’s something else going on—things like digestive issues, food sensitivities, or thyroid problems can all cause inexplicable weight gain, or inability to lose weight. Environmental toxins can also have an impact on our hormones and potentially our weight as well. We have to address these underlying issues to restore hormone balance, and usually some weight loss will occur as a result.
Plus I look at what I call the Big 4 lifestyle factors: in addition to diet, sleep, exercise, and stress are major factors that influence our hormones (and potentially weight). So I work with women to improve their sleep, create healthy and supportive exercise routines and manage stress.
If all these things are in order (diet, sleep, exercise, stress, gut health, thyroid health and any other infections or imbalances are addressed), a woman’s periods should become healthy and balanced, making her fertile and ready for conception.
Sometimes weight loss occurs as a result of working on these imbalances, but the weight is not the main factor. A healthy, supported body will be ready for a baby regardless of the size.
I think it’s time we start supporting women instead of reducing them to numbers.
And suggesting drastic measures like bariatric surgery or liquid diets to rapidly lose weight are not conducive to supporting new life. (I mean really! You think cutting out part of an organ or consuming minimal calories for weeks at a time is going to make your body say “Yes! We have the resources to make a baby” ???) Your body will need time to recover from a major surgery or weight loss, and these should not be given as the best option for immediate fertility.
Fertility clinics should do a better job helping women support their bodies and their hormones by making healthy lifestyle choices and getting at the root cause of their fertility challenges instead of reducing them to a BMI number and writing off their chances.
Until fertility clinics start to make these changes, however, you’ve got us fertility coaches. And that’s why we’re here: to support WOMEN. To help you understand and listen to your body no matter the shape or size.
Want support figuring out the root cause of your fertility? Book an initial coaching session with me and we’ll sit down and chat about your journey so far and you’ll leave with some specific steps you can take to support your fertility. Book here>>
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