Doctors at Dubai Health Authority (DHA) discussed women’s health issues to mark International Women’s Day, which takes place on March 8.
DHA doctors highlighted that despite massive advances in maternal health, one of the biggest challenge facing women of childbearing age in this region is obesity.
Global epidemic
“Many women are now benefitting from massive improvements in care during pregnancy and childbirth introduced in the last century,” says Dr Muna Tahlak, CEO of Latifa Hospital. “Advances in gynaecological fields including laparoscopy and fertility treatments have presented various advanced treatment options that were not available previously.
However, as gynaecologists the biggest challenge in terms of women’s health in our region is the high prevalence of obesity. Obesity really affects a woman’s health in many ways. It can cause fertility issues and complications during pregnancy and childbirth. Sadly, despite advances in fertility treatments, rising obesity rates around the world have had a negative impact on female reproductive health.”
The hospital sees a high number of patients who are overweight or obese at the time they come for pre-pregnancy counselling.
Dr Amal Al Qedrah, Consultant Gynaecologist and Infertility Specialist at Latifa Hospital, says, “It is not uncommon to see patients who weigh 80 to 90kg before their pregnancy; we even have patients who weigh more than 100kg and approach us for fertility counselling. If a woman’s BMI is 35 or above, we do not offer any fertility options because there are many risks associated with pregnancy when the mother is obese."
"Therefore, the first thing we do is devise a comprehensive lifestyle modification plan for her that includes consumption of healthy food and regular exercise. In many cases, weight loss itself can solve several fertility problems, such as irregular periods, and helps boost fertility as it regulates the hormones in the body. Women’s bodies need to be at an appropriate weight to produce the right amount of hormones and regulate ovulation and menstruation.”
Dr Muna adds that certain fertility medicines can cause weight gain and therefore more often than not, the first line of treatment is always weight loss through lifestyle modification.
Associated risks
Dr Amal explains that women who have polycystic ovaries are at a higher risk of putting on weight and they need to take extra care to ensure they do not pile on the pounds. “In the case of polycystic ovaries, it is a vicious cycle: The disease causes weight gain and weight gain can cause the disease. Therefore, for such patients, we recommend going on a diet that is low in processed foods and sugars and we recommend weight training at least three times a week to help regulate the hormones and ovaries. It is a known fact that weight reduction enhances reproductive outcomes.”
She adds that according to several international studies, women who are overweight or obese have less chance of getting pregnant overall. “They are also more likely than women of healthy weight to take more than a year to get pregnant.
“Those who get pregnant need to follow their antenatal plan carefully to prevent complications during pregnancy and childbirth. We advise them to eat healthy foods during pregnancy and limit their weight gain to between 12 and 15kg during pregnancy. This is because the risk of overweight and obese women developing gestational [pregnancy-related] diabetes is much higher than women who have a healthy weight. The risk of pre-eclampsia also increases in overweight and obese women.”
Dr Amal adds that obesity increases a woman’s chances of having a C-section delivery by 20 per cent.
She says that obesity can also aggravate symptoms of pelvic organ prolapse, stress urinary incontinence and increase the risk of endometrial polyps and symptomatic fibroids. Obesity is also linked to a higher chance of developing several diseases such as diabetes, high blood pressure and heart disease.
Dr Wafaa Ayesh, Director of Nutrition at DHA, says, “A BMI between 25 and 29.9 is considered overweight and a BMI over 30 is considered obese. Ideally, women should aim to achieve a BMI in the range of 19 to 24. Weight loss is linked to lifestyle and daily habits — while nutritionists and doctors can provide all the right knowledge and information, at the end of the day it boils down to whether the patient is ready to make the changes needed to achieve the desired results.”
