How to Tackle Obesity and Promote Fertility - Essay Example

How to tackle Obesity and promote fertility Introduction: It is inherent in humans to have a family and procreate, and for a married couple it is their prime requirement to have their own progenies to pet and pamper. Do you know Obesity is a physiological manifestation generally developed from our own bad habits which exacerbate a series of health issues, including infertility? Scientific evidence shows that after smoking obesity is considered as the second leading cause of preventable death. It is found that around one-third of the population in United States is obese, based on the Body Mass Index (BMI) criteria, and obesity alone contributes to 300,000 deaths yearly in United States. Wrong eating and life style habits, genetic and environmental factors, functional variation of endocrine glands, intake of certain drugs, and age are proved to be contributing to obesity. Whether obesity affect fertility is still a complex and difficult issue to fathom, but scientific evidence shows that abdominal phenotype (women with abdominal obesity) is associated with several reproductive disturbances. Research findings prove that Obesity adversely affects almost every system of the body, has a strong connection with menstrual irregularities, and reproductive system is not an exception. Obesity increases the risk of Polycystic Ovarian Syndrome (PCOS) in women, which causes infertility, while obese women who do not have PCOS also suffer infertility problems with some other biological changes that occur in the body due to obesity. Recent researches done on infertile men revealed that obesity has an adverse effect on male fertility as well, and found a direct link between obesity and overall quality of a man’s sperm. Tackling obesity is possible by changing our eating habits and resorting to regular exercise. In special cases medication and even surgical intervention may be adopted. Obesity is primarily a product of our own wrong habits and life style, which primarily obstructs reproductive capacity. When our habit is the main obstacle on the way to personal achievement of reproduction, the basic biological necessity and fulfillment of a person’s aspiration, it is high time for retrospection to overcome the hindrance with individual initiative and professional guidance. The scourge: Obesity is a major medical problem today, and it has grown to epidemic proportion in US and other developed countries. Obese persons can easily be spotted from their general physical appearance, and scientifically the cases are identified on the basis of individual’s Body Mass Index. Obesity in common parlance is defined as excess of body weight compared to normal accepted standard of accumulated fat, and scientifically it refers to body weight that is at least 30 percent over the ideal weight for a specified height in accordance with BMI, and BMI of around 40 or above is considered as morbid obesity. The major symptoms seen in obesity are large body frame, difficulty in doing daily activities, lethargy, and breathlessness. In addition to this it increases the risk of a series of significant health issues such as type 2 diabetes, coronary artery disease, arthritis, hyperlipidemia, gallstones, and certain types of cancer are sure threat of individual’s life itself. Quality and productivity of an individual suffers because of many causes like frequent illness, constant tiredness, and inability to be active because of back pain, joint pain and shortness of breathe. Hence, controlling obesity should be the top most agenda in an individual’s life style. Lack of exercise and intake of high calorie food, especially fiber less fast food promote obesity. The causes of obesity are strongly related with genetic and environmental factors also. It may be worth noting that hereditary factors influence obesity and offspring of obese parents are at high risk to be obese. An individual with genetic predisposition to obesity, who lives in an environment where high fat and high calorie food are readily available, increases the risk of obesity. It is interesting to note that “most women are happy to blame their obesity on hormonal problems … usually the underlying reason for obesity is simple – the caloric intake is more than caloric expenditure” (The patient’s Doctor, 2006) Excessive intake of high calorie food or increased amount of fiber-free food also contributes to the modern obesity epidemic. The type of food eaten plays an important role in the rise of obesity, the over consumption of trans-fats, refined white flour carbohydrates, combined with low fiber intake interfere with food and energy metabolism in the body, and cause excessive fat storage. Age is an important factor for getting obesity, as one becomes older metabolism level in the body proportionately gets reduced. Hence, the excessive calorie of food is converted into fat and is deposited in the body. The functional variation of endocrine glands can also be one of the causes of obesity as women become obese at puberty, during pregnancy, or at menopause. Use of certain drugs proved to be a contributing factor for obesity, for example the disproportionate use of steroids, oral contraceptives, and insulin intake usually contributes weight gain. Above all, reduced energy expenditure is considered as the possible root cause of obesity. People who intake more calories are required to burn excessive calories, otherwise this excess calorie will be stored as fat in the body. Inadequate exercise and excessive intake of calorie clearly contributes to obesity. “People who are obese do not live as long as those who are not obese and the earlier a person become obese; the more years of life are lost” (Kriplani, 2005). Obesity poses a serious threat to the body image, as the accumulation of excessive fat all over the body alters the proper shape of the body and also increases the risk of a series of significant health issues. Severe obesity damages the body by its, metabolic, physiological, and mechanical adverse effects on normal physiological function of the body. These co-morbidities adversely affect almost every organ in the body in some way or other, and cause to secondary life threatening illness. The collective effect of these co-morbidities interferes with the quality of life and can seriously shorten lifespan of the individual. The risks of developing significant secondary medical problems are directly proportional to the severity of obesity. Obesity and its effect on fertility and child birth: How obesity, or the excess amount of fat in our body influence hormonal balance is very interesting to study. There are three sources of estrogen, the female sex hormone, in the body namely ovary, adrenal glands, and fat cells. All the sex hormones are derived from cholesterol, and thus the testosterone and estradiol is lipid soluble, which means they are soluble in fat. These hormones accumulate in the body fat and once they cross the saturation level they reach equilibrium with blood. In addition to the sex steroid hormones in body fat, the gonads secrete testosterone and estradiol to sustain reproductive function. When the equilibrium of sex hormone in the blood increases adipose cells convert the weak male hormone to androstenedione, and the weak female hormone to estrone. Estrone has metabolic influence on the hypothalamic-pituitary axis of the brain which in turn alters the reproductive function. It is well established that these complex interactions have the net effect of impairing reproductive function in obese men and women. For biological reasons women are more likely to be obese than are men, as endocrine glands in women tends to add more fat in the body than men, and in addition women have less muscle mass and tends to burn fewer calories at rest than men do. There are different metabolic pathways for estradiol metabolism in woman depending on body weight. Obese women metabolize estradiol to estriol and progressively produce their alternate estrogens until ovulation stopped and become infertile. Obese woman have excessive estrogen but do not cycle on a regular basis with progressive accumulation of body fat that leads to obesity. This excess fat in the body produces excessive amount of estrogen which in turn develops hormone imbalance that ultimately leads to infertility. In obese adolescent girls, reproductive event starts as normal physiologic event and develops to impairment of reproductive function within a few years. It is evident that obese woman are at increased risk for infertility and other reproductive problem. Obesity has an adverse effect on male fertility also, and has link between obesity and overall quality of a man’s sperm. Recent study reveals that the quality of sperm begins to deteriorate when men become obese, and suggests that those who become obese increase the risks of infertility because their sperm quality becomes very poor. In addition to this, obesity reduces sperm count below the level required to fertilize an egg and even if fertilization occurs, the risk of miscarriage is far greater due to the inferior quality of sperm. While the impact of weight on sperm quality is most drastic in the obese men, the study revealed that even slightly obese men are at risks of developing fertility issues in the near future. It derives that obese men and women are at risk to be infertile and blaming each other will not resolve the problem. In addition to the infertility issues, obese women are also at high risk of complications related to pregnancy. In a recent study presented at the American Society for Reproductive Medicine meeting, it revealed that “overweight women were 50% more likely to have an ectopic pregnancy” (Morris, Randy, S., .). Obese woman are four to five times more likely to experience preeclampsia during their pregnancy. Stillbirth is likely to occur in the pregnancies of obese women than other women. The cases of shoulder dystocia are more reported in the pregnancy of obese women, it occurs when the shoulder of the baby gets caught in the mother’s pelvis during the labor. It is a medical emergency which may result in death or injury to the new born. Babies experience distress during labor more often in the pregnancies of obese women. As a result, the complications result often in delivery by cesarean section than women of normal weight. The babies of obese women are at high risk of neonatal death and recent studies have even identified risk of gestational diabetes in obese women. How to tackle the problem: Statistics show that “more than 70% of women who are infertile as the result of body weight disorders will conceive spontaneously if their weight disorder is corrected through a weight-gaining or weight-reduction diet as appropriate” (Bates, William, G.,). The literature on weight control and its beneficial effect on fertility by Pasquali, R., and others (1997) reveal that obesity may be an important pathogenetic factor involved in the development of hyper-androgenism in women with polycystic ovary syndrome (PCOS). They found that weight loss improves “menses abnormalities, ovulation and fertility rates and reduce hyperandogenism, hyperinsulinaemia, and gonadotrophin pulsatile section alteration.” PCOS is a heterogeneous clinical condition associated with insulin resistance and hyper-insulinaemia, present in obese women. Such patients will have multiple small cysts in their ovaries due to disruption in normal menstrual cycle which prevent ovulation. Insulin is a physiological hormone regulating ovarian function, and insulin resistance will negatively affect menstrual cycles and fertility rate. Among several other mechanisms, hyperinsulinaemia plays a fundamental role, due to its gonadotrophic function, which has been demonstrated both invitro and invivo. They recommend weight loss as first-line therapeutic option in women with obesity and PCOS. Favoring weight loss and maintenance, as well as improving insulin resistance plays a complementary role to lifestyle intervention. The following words of William, G. Bates, (2007 also carry bright prospects for obese persons who are willing to reduce their body weight. “Body fat plays a critical role in human reproduction.  Both excess and deficiency of body fat lead to reproductive failure. Body weight disorder is one of the first potential causes of reproductive failure in both men and women. This is a problem that can be corrected by the active cooperation of affected individual and the infertile couple” Practicing appropriate eating habits that promote weight loss must include controlling calorie intake. Consuming more plant based fiber rich food, such as fruits, vegetables, and whole grains definitely help you to control excessive calorie intake. Promote variety of food in the diet, which is less in calorie, to help you achieve your goal without being deprived of nutrition. Limiting sugar and other refined carbohydrates and some fat produces are the easiest way to cut back on your calorie intake. A diet must be established “according to the proper dietary guidelines, depending on your height, weight and concurrent health” (AOA, 2005). To overcome this challenge behavior modification therapy is an integral part of all weight loss modification programs. To help individual to comply with physical activity and dietary changes behavioral modification programs help an individual to coordinate diet and exercise to achieve his goal. The main strategies in behavioral modifications are stress management, social support, and stimulus control. A combination of behavioral therapy, diet therapy, and physical activity is considered as the safest way of weight loss. In difficult situations drug therapy may also be adopted. Drug therapy is considered as the last option of therapy. Drug therapy can be used when one fails all other mode of therapy. Drug therapy is also utilized as a part of comprehensive weight loss program with diet, exercise, and behavioral therapy. Medication contributes weight losing by decreasing the appetite or by inhibiting the absorption of fat from the intestines. However, our will to change life style, with putting control on our palate and engaging in regular exercise will change the condition and succeed in becoming a parent. You should not lose hope from what you read from different discouraging articles on obesity, as there are many simple and effective ways to change the condition and become fertile. Lifestyle modifications such as increasing physical activity and decreasing calorie intake are helpful to treat obesity. Changes in dietary habits and increased physical activity to reduce weight, therefore, are important to improve hormonal and metabolic abnormalities, which will favor ovulation and promote fertility. Obesity, of course has reached epidemic proportion with our wrong eating habit and life style, but with individual effort it could be surmounted and we all can have a successful family life. Works cited AOA. Fact sheets, Obesity Treatment. 2005. 9 Dec. 2007. . Kriplani, A., K. Health Hazards of Morbid Obesity. Obesitysurgeries.com, 2005. 9 Dec. 2007 . Bates, William, G., Prevention of Infertility Source Document, Abnormal Body Weight: A preventable Cause of Infertility. 2007. 9 Dec. 2007. . Pasquali, R., Casimirr, F., & Vicennati, V., Weight. Control and its beneficial effect on fertility in women with obesity and polysystic ovary syndrome. Human Reproduction Suppl. 1:82-7. NCBI: Pubmed. Oct. 12, 1997. 9 Dec. 2007. . Morris, Randy, S. Society for Reproductive Endocrinology and Infertility. IVF clinic and infertility treatment program, Naperville and Chicago Illinois. 9 Dec. 2007. . The patient’s Doctor, 25 Jun. 2006. 9 Dec. 2007. . Read More