After 6 months in the Obesity-Fertility program, participants with obesity and subfertility reported significantly improved diet quality, physical activity level, and sedentary behavior, according to a study published in Clinical Nutrition ESPEN.1
“Female infertility, or subfertility (ie, reduced fertility), is often due to anovulation, which in almost three-quarters of cases is caused by polycystic ovary syndrome (PCOS),” wrote authors of the study. “PCOS is a major risk factor for the development of type 2 diabetes and cardiometabolic conditions and is induced or exacerbated by obesity. In North America, 50%-75% of women with PCOS are living with obesity.”
With 41.9% of US women having obesityand 13.4% with impaired fertility,2,3 complications surrounding PCOS and giving birth in general are a real concern for expecting mothers and their providers. With just 12.2% of women 15-49 utilizing available infertility services,3 researchers are wondering how to improve the delivery of both reproductive care and obesity management.
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Goals of the Obesity-Fertility Program
This led researchers of the current study to develop the Obesity-Fertility lifestyle intervention, which is a women’s health fertility clinic designed specifically for women with obesity and subfertility. In its first analysis, the intervention program was found to significantly improve fertility outcomes. Now, researchers have performed a secondary analysis of behavioral lifestyles among program participants to further address this link between infertility and obesity.1
“The available literature shows that those living with obesity have increased barriers to fertility and accessing treatments available to the general population,” according to a study published in the International Journal of Gynecology & Obstetrics.1 “There is considerable scope to further improve practice, in that obesity must be addressed as a potentially conquerable barrier to fertility.”
Through the use of the Obesity-Fertility clinic, researchers of the current study hoped to provide practice improvements in order to further drive improved fertility, and now obesity, outcomes among study participants. Their goal was to understand whether or not the program led to healthier lifestyle behaviors among its patients.
The Program’s Secondary Analysis
Researchers conducted the secondary analysis of an open-label, randomized controlled trial that explored the live birth rates of Obesity-Fertility program participants as the primary outcome. The current study, however, randomized women into lifestyle and control groups, comparing outcomes within the program between the two.
To separate the 2 groups, those included in the control were simply given the usual care commonly provided at fertility clinics. Participants in the lifestyle group were instead given opportunities to meet with a dietitian and a kinesiologist in both group and individual settings. In order to report on participants’ change in lifestyle behaviors, researchers recorded patients’ food consumption, physical activity, sedentary time, and smoking and alcohol use before the study and 6 months after the Obesity-Fertility intervention.
The final analysis of the program included a total of 85 participants (mean age, 30.1 years; mean body mass index, 39.8 kg/m2) randomized to either group. While 42 participants were placed in the lifestyle group, the other 43 were included in the control group.
“This study shows that the Obesity-Fertility lifestyle program, which is based on motivational interviewing and coaching by a trained dietitian and kinesiologist, is effective in improving lifestyle behaviors in women with obesity seeking fertility care, with a trend toward improved functional exercise capacity (an objective measure),” continued authors of the current study.1
Successfully Improving Women’s Lifestyle Behaviors
According to the researchers, the Obesity-Fertility program was successfully effective in improving 3 aspects of participants’ lifestyle behaviors: diet quality, physical activity, and sedentary time.
First, the program was found to encourage participants’ self-promotion of healthier foods and drinks. It also helped them prioritize eating healthy breakfasts, limiting sugary drinks, and increasing consumption of whole fruits, whole grains, and dairy products. For improvements in physical activity, those in the lifestyle group were 30% more likely to walk longer distances for exercise than patients in the control group. Finally, the program was also found to lead patients toward less time spent on their devices and participating in generally sedentary behavior.
Future research will further report on how programs like Obesity-Fertility can be adopted on a larger scale and how health care leaders can streamline access to resources that improve lifestyle behaviors for women with obesity and those that are infertile.
“Our results show that the Obesity-Fertility lifestyle program can significantly improve diet quality, physical activity level, and sedentary time, in addition to anthropometric measures and fertility outcomes, as previously reported,” concluded the authors.1 “Therefore, such programs can support women with obesity and subfertility to adopt healthier lifestyle behaviors.”
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