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Why Do We Talk About Weight at a Fertility Clinic?

September 9th, 2022 | 7 min. read

By Monica Moore, MSN, APRN

An appointment at the doctor generates anxiety for many people. Whether it’s getting your blood drawn, having to undergo a painful but necessary procedure or test, or the fear of receiving bad news, going to the doctor’s office doesn’t feel like a walk in the park for most folks. 

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Acknowledging the Impact of Weight Bias

For those who struggle with their weight, the stress typically starts waaaay before they even walk in the door. Just the thought of having to step on the scale to be weighed can generate strong feelings of anxiety, self-judgment, discomfort or embarrassment.  

Many people in bigger bodies have experienced some form of weight bias, even (sadly) from the health care professionals who are there to take care of them. At times, it can feel that your physician is focused more on your weight than on the issue that brought you into the office. 

Knowing this, why do fertility specialists even talk about weight at all? Wouldn’t it be easier to not bring it up? There are many reasons why your doctor may bring up your weight, but here are three important ones. 

3 Reasons Why This Conversation is Important 

First, it is clear that both extremes of body weight - either very low or very high body mass index (BMI) can negatively affect your fertility, says Dr. Josh Hurwitz. This is true for both women and men. Finding a healthy weight for you and adopting healthy lifestyle changes are important no matter which end of the spectrum you fall on.

Second, pregnancy has been identified as a key period in a woman’s life that is associated with a high risk for weight gain. Trying to conceive is an important intervention period for preventing large weight gains as we all know that once weight is gained, it is difficult to lose. 

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Your fertility specialists are provided a unique opportunity to see you frequently before pregnancy and it would be irresponsible of us to not offer you methods that support healthy weight gain in pregnancy.

These methods can help optimize your health during this important life stage. Not only can optimizing your metabolism now sometimes help you become pregnant, but it can also decrease potential pregnancy complications and set you up for future health and success. 

Third, as uncomfortable as it can be, by not discussing it, we would be giving you incomplete guidance. As healthcare providers, it is always our job to do our very best to help you achieve pregnancy and overall wellness. 

The Truth: It's Not All Your Fault 

As reproductive endocrinologists, we also understand and appreciate that there is a robust hormonal contribution to gaining and retaining weight. For example, being resistant to the hormone insulin can skew your appetite regulation system and make you feel hungry, even when you have had enough to eat. 

There is another hormone called leptin that is produced after eating. For some people, the brain doesn’t sense leptin production adequately, so the signal to stop eating is either delayed or non-existent.

These hormonal pathways can impede our ability to rely on intuitive eating because it often causes one to feel hungry, yet rarely feel full.

We recognize that healthy people come in all shapes and sizes and that the factors that lead to increased body weight are incredibly complex and often not under our control. 

Understanding External Factors

Did you know there is a strong genetic component that predisposes some people to weight gain? There are many factors outside of one's control when it comes to weight - meaning that for many people, the oversimplified "eat less, move more" advice simply doesn't solve the problem

It is important to acknowledge that we also live in an environment where many external factors promote weight gain, such as the availability of ultra-processed food and portion sizes that continue to increase.

Many cities don’t have bike lanes or safe places to walk in neighborhoods and, during a pandemic, many have been reluctant to go to an indoor gym - making a regular exercise habit or movement practice more difficult to keep up. 

Ultimately, our main goal is to help you achieve a healthy pregnancy. In keeping with this, we do recommend adopting healthy lifestyle changes regardless of whether they affect your weight

You don't necessarily need to lose 50 pounds to make a big positive impact on your health! Adopting simple but consistent lifestyle changes is the most important, sustainable action you can take. 

Have Polycystic Ovary Syndrome (PCOS)? Download our free PCOS Handbook and explore our PCOS Resources guide for help navigating life and fertility with PCOS. 

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The Good News? You're Not Alone

At Illume Fertility, we can help you achieve this by offering a full range of care:

What If I Don’t Want to Be Weighed?

If you are someone in recovery from disordered eating or prefer not to discuss your exact weight, know that our team will respect your wishes. 

Here are three things you can request:
  1. To step onto the scale facing out so that you don’t have to see the exact number
  2. That your Care Team does not reference your exact weight during visits unless absolutely necessary
  3. If working with our nutritionists, talk about your history and discuss anything that might be challenging for you (i.e. feeling restricted) so you can work together to create the most successful plan for you

What to expect at your first appointment:

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We're Here to Support You

If you feel nervous about booking that first appointment or worry that weight will be an issue, please remember that our job is to support you on your journey, not pass judgment on your body! 

Our ultimate goal is always the healthiest parents, pregnancy and baby possible, and everything we do gets you one step closer to making your dreams a reality.  

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Monica Moore, MSN, APRN

Monica Moore is a board-certified Advanced Practice Nurse Practitioner, nurse educator and health coach who has been caring for patients at Illume Fertility for over 20 years. She is also the founder and lead educator at Fertile Health, LLC. Monica is passionate about taking care of the whole patient, believing in the importance of integrating comprehensive care. She has a special interest in PCOS and combating weight bias with education and advocacy.