Overweight, obesity and fertility

Overweight and obesity are two major problems not only of public health, but also of global health. Overweight is defined as having a body mass index (BMI) of more than 25, while obesity is diagnosed when the BMI exceeds 30.

According to the World Health Organization (WHO), obesity has tripled since 1975 to 1.9 billion adults, about 13% of the world's population. In addition, the World Obesity Federation predicts that – by 2035 – half of the global population will be obese. Lifestyles and eating habits are determining factors for the development of overweight and obesity, and these, in turn, negatively affect fertility. Problems related to body weight, in fact, have significant impacts not only on conception but also on the course of pregnancy and on the long-term health of mother and child.

The mechanisms that determine how obesity is associated with fertility have been specifically addressed in the scientific literature. At the molecular level, adipose tissue produces cytokines, including a subgroup called adipokines, which act directly on fertility. High levels of adipose tissue are also associated with polycystic ovary syndrome, a condition that can impair fertility. In overweight or obese women, the follicular fluid, which is essential for the proper development of ovarian follicles, has altered characteristics, negatively affecting fertility. It is important to note that overweight and obesity not only affect fertility but have a considerable impact on pregnancy, leading to an increased risk of glucose intolerance, gestational hypertension, preeclampsia or prematurity. In addition, they can impact the mother's overall health, becoming risk factors for high blood pressure, diabetes, or other conditions. In the studies "A comprehensive assessment of preconception health needs and interventions regarding women of childbearing age: a systematic review" and "Knowledge, attitudes, and health status of childbearing age young women regarding preconception health - an Italian survey", conducted by the Center for Research and Studies on Procreative Health, the impact that knowledge on preconception health was analyzed. The habits and health status of women of childbearing age have on their fertility. In a survey of 340 women between the ages of 18 and 25, it was found that more than half had a BMI in the normal range (18-25), some were overweight and a small percentage were obese, while just over 10% were underweight, a condition that - like being overweight - can negatively affect fertility. The results of this study showed a correlation between BMI and knowledge about fertility and preconception health. Women with a normal BMI had a greater awareness of fertility and preconception health. These findings suggest that targeted educational interventions, geared towards raising women's awareness of the risks of overweight and obesity, can improve their overall health and optimize fertility. These training interventions are therefore essential to prevent weight-related problems and promote an ideal state of health for conception and pregnancy.