On this episode of Fat and Fertile, we explore the myth that weight loss and dieting will fix fertility.
We look at three different assumptions that mean that the idea of dieting as a fertility fix persists and the one piece of advice I give all my clients around food.
Mentioned in this episode:
Free resource – Fertility Research for Fat Folks
Resources around Intentional Weight Loss
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Thanks for tuning in to episode 3 of fat and fertile the podcast. In this episode we will be covering the persistent myth that dieting and/or weight loss is the solution for fat people to fix their fertility.
We’re going to explore three main points around the idea that dieting and losing weight will help you get pregnant.
First things first, unless you’ve had a blood test or scan that shows there is something specific going on, there is no reason to assume that you need to fix your fertility.
Doctors do not possess X-ray eyes where they can diagnose you based on your body size, that is not how medicine works.
If there is an issue then it needs to be diagnosed with the proper tests and using the diagnostic parameters. A classic example of this is PCOS or Polycystic Ovarian Syndrome. I’ve lost track of the amount of people I’ve spoken to who’ve been diagnosed this based on body size alone. That’s not medicine, that’s bias. PCOS has a set of 3 specific criteria – irregular cycles, cysts on ovaries and increased testosterone – 2 of which need to be met before you can be diagnosed.
Fatness does not equal unhealthy and fatness is not a cause of fertility issues. Just because you are fat, that does not mean that there is anything wrong with your hormones or body that is making it more difficult to get pregnant, which is why prescribing weight loss or dieting is absolutely not evidence based and wholly unethical.
The second piece of this puzzle is that most clinicians wrongly assume that we can easily change our weight without any negative side effects.
The reality is that weight is non-modifiable. What do I mean by that? You cannot control your weight. The mantra “eat less, move more” grossly oversimplifies the incredible complex nature of your body. Your weight is controlled by over 100 different factors [note this reference contains stigmatising language and ideas] and we know from decades of research that any form of intentional weight loss ultimately fails. There are books and countless studies on this so I will reference some sources in the show notes (see above) for you to go and research this idea further but in a nutshell – whenever you’ve been on a diet and it’s failed, it’s not your fault. For all diets, you’ll likely lose a little weight in the short term but the majority of folks will go on the regain any weight loss – not because you are lazy or unmotivated – it’s because diets don’t work. No diet has any evidence that it works long term.
But what’s the harm you might ask? Welll….. it turns out lots!!! Dieting leads to disordered eating patterns and eating disorders and it can have a huge negative impact on your mental health. Think of all the time, energy and money you’ve spent focused on diets, weight loss and food. I spent the majority of my teens and twenties hyperfocused on making my body smaller – my whole life revolved around following a diet, failing a diet, moving onto the next one and the cycle continued. When i finally said enough is enough – the amount of brain space I then had free to think about other things was huge.
You might have heard the commonly used “if you just lose 5-10% of your body weight then your body will become more fertile” line used by countless doctors and websites.
So let’s explore why this is total bullshit
Firstly it makes no sense! Let’s think of an example, say we have someone has a high BMI. They lose 5% of their body weight and they are still have a high BMI. How can this person suddenly become more fertile than someone who was that weight to start with?
It’s almost like it’s not actually about the weight……..
And it isn’t, which is the whole point
What is actually going on when doctors see this happening is that often folks are changing their behaviours. And some of those behaviours will be supportive to their fertility
– Things like moving your body
– Drinking more water
– Eating more fruit and veg
It’s not the restriction of dieting or the weight lost that is making the impact, but the behaviour changes.
And that has been shown in research, one study looked a two groups of people, the first took part in health promoting behaviours, the other group didn’t and what they found was that the people who did the behaviours saw a positive impact on measurable outcomes like blood pressure and blood sugars regardless of whether their weight went up, went down or stayed the same.
Yet the majority of studies don’t separate out the impact of the behaviours vs the weight change.
But what about fertility diets I hear you ask? Surely eating the “right” foods will help be get pregnant faster even if my weight doesn’t change?
Dieting (in any form) is basically telling our body that it is in famine mode and evolutionary speaking that meant that it was a terrible time to get pregnant so our body’s learnt that when there is a famine going on that you need to save resources as much a possible, including shutting down reproduction until a time when food is available and you’ll be able to get enough food to sustain you, your pregnancy and your future baby.
OK well what about all these thousands of fertility diets that show I have to cut out sugar and coffee and dairy and add all these different foods to get pregnant they must be right?
I totally understand why these fertility diets have become so popular. Food is one thing that we can control out of a million things that feel outside of our control when it comes to fertility.
I want to introduce you to the social determinents of health. These are things that have been studied on a population level to find out what impacts our health. The majority of our health is impacted by things beyond our control like our genes and biology, our access the healthcare, our access to food, clean water, shelter etc All the so called lifestyle factors make up about 15-20% of what impacts our health and that bracket includes sleep, how we react to stress, hydration, food, movement – everything! We are sold the idea that food and exercise rule our health but actually they may up a tiny portion of what impacts our health.
Restricting our food especially if you are someone with a history of disordered eating can cause more stress and that can rule out any potential benefit
If you think about food on a global scale – we eat a tiny portion of what foods we could eat on the planet so why are these the food that make up a balanced diet? It’s purely based on what foods are trendy, what foods western culture has deemed acceptable, what health slogans companies are marketing their products with and how we’ve cultivated food over time.
The only piece of nutrition advice I ever give folks is “eat enough” FULL STOP that can be harder than you think, when we’ve been taught to undernourish our bodies for years through diets and ideas of what we “should” be eating. As long as you are getting carbs, fat and protein and your body is getting enough energy to feel safe and thrive – that is going to be what signals to your reproductive system that it’s safe to get pregnant
I know how hard it is to move away from the constant message that you need to change what you eat or the size of your body to improve your changes of getting pregnant.
And no matter what action you’ve taken in the past, you were only doing your absolute best with the information you had
This is what I’d love you to take away from this episode:
Fat bodies are so capable of getting pregnant
Your weight isn’t within your control to change
You don’t need to find yet another fertility diet to get pregnant
Sending you so much love as you navigate this