A multidisciplinary approach to weight management and reproductive care: a retrospective cohort study on weight loss through personalized and patient-centered care.

Abstract

Background: Obesity is a highly prevalent chronic disease with a significant and complex impact on reproduction. National guidelines recommend weight loss prior to pregnancy for patients with obesity to mitigate complications and increase fertility; however, targeted, personalized interventions are limited. The objectives of this study are to describe the implementation of a multidisciplinary program designed specifically for women with reproductive disorders and obesity and to report differences in baseline characteristics and weight loss outcomes between women willing vs. not willing to defer pregnancy attempts to focus on weight loss.

Methods: Retrospective cohort study at a university multidisciplinary program for women with reproductive disorders and obesity. All participants from program initiation (November 2021) through July 2023 were included in the analysis. Primary outcome was percent body weight loss at 3 months. Secondary outcomes included weight loss at 6 months and achievement of > 5% and > 10% weight loss at each time point.

Results: A total of 237 participants were included in the analysis. The majority of participants (88.2%) desired pregnancy. 63.2% of participants who desired pregnancy were willing to postpone pregnancy attempts/fertility treatments so that they could focus on weight loss for at least 3 months. Participants willing to defer pregnancy attempts achieved a significantly greater weight loss at 3 months compared to those who continued pregnancy attempts (mean - 4.8% vs. -2.5%, p = 0.004) and were more likely to achieve > 10% body weight loss at 3 months (14.0% vs. 2.20%, p = 0.031). Those who achieved > 5% weight loss by 6 months were more likely to achieve pregnancy within the first 6 months of trying to conceive (34.1% vs. 7.7%, p = 0.004).

Conclusions: We describe the development and implementation of a multidisciplinary program for women with reproductive disorders and obesity seeking weight management. An individualized approach to weight management and reproductive care results in clinically significant weight loss especially among women willing to defer pregnancy attempts and focus on weight loss for at least 3 months.

Trial registration: Clinical trial number: Not applicable.