Article By: Rachel Ignomirello, MS, RDN, CSOWM, LDN
Rachel Ignomirello is a Bariatric Dietitian and Board-Certified Specialist in Obesity and Weight Management.
There are countless myths related to pregnancy and fertility thanks to unsolicited word-of-mouth, unchecked social media posts, and unscientific webpages. In today’s blog, I’ll be busting some of these myths and how they may relate to bariatric patients.
1) Infertility is not common. Many women know how painfully untrue this is. Infertility is common, affecting about 1 in 8 couples in the United States. Obesity worsens fertility in both men and women, which means those rates are higher in pre-op bariatric patients. After surgery, there’s a huge improvement in fertility and conception. In a study from 2004, almost 50% of the women who were unable to conceive before bariatric surgery became pregnant after surgery.
2) It's just women who are affected by infertility. Efforts in the sheets do not always translate to success for people with obesity. It’s true that sexual dysfunction is more common for women with obesity, but it takes two to tango. Men with obesity have lower sperm counts and a higher rate of erectile dysfunction. Both men and women have improved fertility thanks to weight loss from bariatric surgery.
3) Bariatric patients will have the same sex drive after surgery. After bariatric surgery, many patients actually report improved sex drive or “libido.” After weight loss, hormones are better regulated, body confidence and self-esteem increase, joints hurt less, and there’s more energy. Most programs will encourage waiting 1-2 weeks before restarting normal sexual activity.
4) Patients can try to get pregnant right after surgery. According to the American Society for Metabolic and Bariatric Surgery (ASMBS), patients of reproductive potential need to wait at least 12-18 months after surgery. I generally encourage waiting 24 months to conceive to maximize weight loss goals. This is because weight loss and nutrition status (diet/vitamins) need to stabilize. It’s very high risk to become pregnant within the first year; there is a higher rate of prematurity and smaller gestational size.
5) Pregnancy is dangerous for postoperative patients. Quite the opposite. Between 2007-2018, there was a large study with over 20,000 pregnancies. Researchers discovered that bariatric surgery was associated with a decreased risk of gestational diabetes, preeclampsia, amniotic infection, fetal macrosomia (large size), and NICU admissions.
6) Pregnancy guidelines are the same for pre- and post-op patients. Bariatric patients have specific nutrition needs during pregnancy, so things won’t be the same. Here are some examples. Vitamins will have to be adjusted to bariatric prenatal supplements. There may have to be more frequent meals and snacks since stomach pouch sizes are smaller. Because oral glucose tolerance tests are not tolerated well and risk dumping syndrome, patients may have to measure their blood sugar management in a different way.
7) It is not safe to exercise during pregnancy. Exercise during pregnancy is important and healthy for both mom and baby. Bariatric patients are encouraged to be active for weight loss and muscle mass maintenance. Swimming and walking are smart choices during pregnancy. The only activities that should be avoided are ones where a fall may occur like skiing and contact sports. However, patients may need to talk to their doctor about how to become more active slowly and safely if they were not before pregnancy.
BariMelts provides general recommendations, not to be construed as medical advice. Please consult your doctor.