Obesity and its effects on women's health and pregnancy
In the name of God, the most gracious, the most merciful
Obesity and its effects on women’s health and pregnancy
Dr. Jamil Shaaban
Consultant in Obstetrics, Gynecology, and Obstetrics
Obesity is the scourge of our time: Excessive weight gain has become a common phenomenon in societies worldwide. Obesity rates have increased in recent decades in all countries, both developed and developing, among all ages, from children to adults, and across all social classes, rich and poor, and among men, women, and children.
What is obesity? Obesity is weight gain due to the accumulation of excess fat in the body. This results from an imbalance between energy intake from food and drink and energy expended by the body. This occurs in the following cases: Excess energy intake. Deficiency in energy expended.
A person is considered obese if their weight is 20% more than their normal weight according to age and height, and if their body mass index (BMI) is 30 or more.
Waist circumference measurement: Fat accumulated around the middle is the most important indicator of obesity-related diseases. Care should be taken to monitor weight if your waist circumference is greater than 88.5 cm for women and 92.5 cm for men.
Body Mass Index (BMI): Divide the weight in kilograms by the square of the height in meters. For example, a person whose height is 1.6 m and weight is 80 kg. BMI = 80/(1.6×1.6) = 31.25. This person is considered obese.
Does obesity affect pregnancy? There is no doubt that this matter is in the hands of God Almighty, as God Almighty says: “To God belongs the dominion of the heavens and the earth. He creates what He wills. He gives to whom He wills female [children], and He gives to whom He wills males. Or He pairs them [with other males] and females. And He renders whom He wills barren. Indeed, He is Knowing and Competent.” (Ash-Shura 49-50)
However, obesity can indeed affect a woman’s fertility and chances of pregnancy, as it can cause ovulation problems, problems with the fertilized egg implanting in the uterus, and problems with in vitro fertilization (IVF) procedures.
The consequences of obesity not only lead to delayed pregnancy, but may also extend to early miscarriages, uterine bleeding, and other health problems.
The relationship between obesity and delayed pregnancy is often overlooked by women who believe that obesity only affects a woman’s physical appearance. They don’t realize that obesity has serious effects on the body and health, including pregnancy, as female hormones and ovulation are significantly affected by weight gain.
Obesity has many complications and symptoms that vary among women. Female hormones and ovulation are significantly affected by weight gain, as fat cells secrete the hormone leptin, which disrupts the function of the pituitary gland, which controls the function of the ovaries.
Obesity also leads to elevated insulin levels, which directly affects the ovaries and alters their activity. As a result, the ovaries may stop functioning and stop ovulating. This leads to several complications, including irregular menstrual cycles, increased facial and body hair growth, hair loss, and increased acne on the face and back. These complications may vary from one woman to another depending on the nature of the ovaries. Women who suffer from polycystic ovary syndrome (PCOS) are more susceptible to these complications.
Scientific studies and practical experience have proven that women who are overweight need more time to become pregnant.
Obesity does not prevent pregnancy, but being overweight may delay pregnancy, i.e., temporarily prevent it, due to irregular ovulation. The chance of the egg being implanted in the uterine lining is also lower due to a defect in the uterine lining, which prevents the fertilized egg from implanting. God Almighty says: {Read in the name of your Lord who created. He created man from a clot.} meaning from the fertilized egg that attaches to the uterus.
Even with the use of ovarian stimulating medications and assisted reproductive procedures such as IVF, excess weight remains a negative factor in the chances of successful pregnancy due to the hormonal imbalances that accompany weight gain.
The complications of obesity do not stop there. Its impact on pregnancy may be even more serious, as excess weight increases the risk of premature miscarriage, a slight increase in some congenital malformations, and increases the incidence of gestational diabetes and high blood pressure, which may lead to an increase in cases of preeclampsia, an increased need for cesarean sections, and an increase in birth weight, along with an increase in birth complications, including postpartum bleeding.
The risks of being overweight on general health are numerous, including diabetes, high blood pressure, heart disease, atherosclerosis, blood clots in both veins and arteries, back pain, joint erosion, especially in the knees, gout, gallstones, breathing and sleep disorders, and an increased incidence of uterine cancer.
There are many ways to help lose weight and maintain a normal weight. The most important is a change in lifestyle, which includes modifying diets and increasing energy consumption through exercise.
There are many medications for weight loss and many recipes for different diets, the best of which are those mentioned in the Holy Quran and the Noble Hadith. God Almighty said: “And eat and drink, but be not excessive. Indeed, He does not like those who commit excess.” (Al-A’raf: 31)
As the Prophet, may God bless him and grant him peace, said: “The son of Adam has not filled a vessel worse than his stomach. If he must do so, then one-third for his food, one-third for his drink, and one-third for his breath.” (Narrated by Al-Tirmidhi)
As for surgical operations, they have developed significantly. Obesity treatment operations have become safer and offer better results. These operations may be suitable for many individuals who suffer from morbid obesity.
I do not recommend surgical procedures, as they may still cause complications. Rather, I recommend adopting non-strenuous diets as a lifestyle and adhering to them.
Obese women are exposed to risks to the health of the mother and child. Children born to obese mothers are more likely to develop birth defects than those born to normal-weight mothers. Neural tube defects affecting the spine (spinae) are nearly twice as likely to occur in children of obese women.
Other common birth defects in obese women include mouth malformations, heart defects, hydrocephalus, and abdominal wall abnormalities.
Recent studies also show that maternal obesity may be a risk factor for fetal death in the womb.
Overweight mothers also have lower rates of breastfeeding, and breastfeeding has many positive effects, including preventing childhood diseases and future obesity.
Summary: Obesity during pregnancy increases the risk of various pregnancy complications:
- Gestational diabetes
- Preeclampsia: High blood pressure, increased protein in urine, fluid congestion in extremities, may worsen with eclampsia
- Higher susceptibility to urinary tract and post-delivery infections
- Blood clotting risk
- Sleep breathing disorders, including sleep apnea
- Delayed delivery date
- Increased likelihood of cesarean section and related complications
- Miscarriage or stillbirth
- Health problems for the fetus or newborn, such as large birth weight
Finally, I pray to God Almighty for safe pregnancies and guidance to avoid obesity and its complications. We must adhere to the words of God Almighty and the Prophet, may God bless him and grant him peace:
God Almighty said: “And eat and drink, but be not excessive. Indeed, He does not like those who commit excess.” (Al-A’raf: 31)
The Prophet said: “The son of Adam has not filled a vessel worse than his stomach. If he must do so, then a third for his food, a third for his drink, and a third for his breath.” (Narrated by Al-Tirmidhi)
The Prophet said: “I have left among you two things. As long as you hold fast to them, you will never go astray: the Book of God and my Sunnah.” (Narrated by Imam Malik)
I conclude with a prayer: “And say, ‘My Lord, increase me in knowledge.’” (Taha: 114)
