St. Petersburg, Fla - Welcoming a newborn is something many couples dream of doing, but it can get complicated when conceiving becomes a roadblock. Infertility affects one in six people, but obesity can also be a problem. When diet and exercise aren't enough to lose weight, bariatric surgery can become an option. Yet a new national survey by Orlando Health finds that 56% of Americans do not know that bariatric surgery is an effective way to improve fertility.
"Every day we have more patients who are looking for bariatric surgery as a solution for several medical conditions, including infertility," said Alexander Ramirez, MD, FASMBS , Director of Orlando Health Weight Loss & Bariatric Institute - Bayfront . "When female patients are struggling with obesity and pregnancy, there is typically a correlation between their weight and infertility."
The survey highlighted Americans' lack of knowledge of this correlation. When asked if they agree with the statement that being overweight negatively affects fertility, half (50%) responded that they either don't know or neither agree nor disagree with that statement.
Obesity is a chronic disease that presents many serious health conditions, including diabetes, hypertension, sleep apnea and the increased risk of several different cancers. And additionally for women struggling with obesity; irregular menstrual cycles, hormone imbalances, and even polycystic ovarian syndrome (PCOS) – can all contribute to infertility.
"We have many patients with PCOS, a hormonal condition that affects women of reproductive age, many of whom try and fail to get pregnant for many years," said Ramirez. "After bariatric surgery, their chances of conception drastically increase very quickly as their hormones are regulated and their menstrual cycle normalizes."
Although other weight loss options, like GLP-1 medications may seem like the easier solution, the survey also revealed 64% of people either don't know or neither agree/disagree that stopping GLP-1 injections can lead to weight gain. Ramirez says bariatric surgery is usually the more effective and longer-lasting option, as it permanently alters the digestive system, increasing the production of hormones and helping the body to ovulate.
"We want women to become pregnant at the right moment, when it's the right time in their lives and also when it's safe," said Ramirez, who recommends waiting between 18 to 24 months before trying to conceive after bariatric surgery.
By waiting, the body is able to recover and adjust to the changes from surgery, including digesting the right amount of nutrients. Ramirez says this transitional period helps decrease complications during pregnancy, including hypertension, preeclampsia and gestational diabetes.
For 38-year-old Karla Grimmett, bariatric surgery became a necessity when her type two diabetes, driven by obesity, landed her in the intensive care unit. Grimmett weighed 380 pounds and knew a gastric bypass procedure was the best decision for her health. Yet, she never imagined it would also correct her fertility issues.
"I've been told since I was 11 that I would never have kids because of polycystic ovarian syndrome," said Grimmett. "I've always been overweight. And because of all my medical issues with high blood pressure and all of that, they just said it was never going to happen."
After bariatric surgery, her health began to improve. She went from taking 12 medical prescriptions a day to two, and she had a regular menstrual cycle for the first time in years.
"Right after I had surgery, I started getting it every single month like clockwork, no issues. And then when it didn't come in April, I was like, 'It can't be,'" said Grimmett. "And I went and got a pregnancy test and I still didn't believe it, so I went and bought four more."
Grimmett gave birth to her daughter, Everleigh, in November of 2022, something she never dreamed was possible.
"She's full of life. She keeps me on my toes, but she's definitely the best thing that ever happened to me," said Grimmett. "I had just given up hope that I would ever get pregnant and have a child."
Dr. Ramirez says it's important for people to understand the connection between obesity and serious health issues, including infertility. For those who are unable to achieve a healthy weight through lifestyle interventions like diet and exercise, it may be time to speak to your doctor about bariatric surgery.
"My advice for anyone with obesity, and especially for those who want to have a child, is to ask about bariatric surgery because it's the most powerful tool we have to lose weight in a healthy way and keep obesity in remission," said Ramirez. "And that is going to increase their chances of having a successful and healthy pregnancy."
