In the UK we are blessed to have the NHS (National Health Service) – free healthcare for all! I love our NHS and am very passionate about what it stands for but there are restrictions on budgets which leads to funding decisions – and more often than not – cuts.
Nice (National Institute for Health and Care Excellence – the agency that provides national guidance and advice about healthcare) states that every woman in the U.K. under 40 should have access to 3 rounds of IVF if they have not been able to have a baby after 2 years of unprotected sex
In the guidelines they state that:
“Women should be informed that female BMI should ideally be in the range 19–30 before commencing assisted reproduction, and that a female BMI outside this range is likely to reduce the success of assisted reproduction procedures.”
It’s up to individual areas to decide how to spend their budget. In most areas the available funding is one cycle at best – some don’t offer any at all. This is a diabolical situation with couples being forced to sell their car, remortgage their houses and wrack up huge credit card bills just to have a baby. Don’t even get me started on the extortionate charges from many IVF clinics in the UK.
But what about fat women?
Another criteria placed on access to fertility treatment in the majority of areas is a BMI limit of 30. This is not a limit placed by the NICE guidelines and the evidence that a BMI of 30 as a suitable restriction is insufficient.
In fact BMI alone as a measure is pretty meaningless. BMI was created to look at populations of health not individuals and gives no meaningful indication to the health of the individual and her individual likelihood of IVF being successful.
Research in 2010 (here is the link if you want to look at the study) showed that there was very limited evidence to support any of the arguments used to restrict IVF based on size.
They found a insufficient evidence that shows any relationship between high BMI and reduced birth rates. They also saw no significant difference in miscarriage rates or other pregnancy complications with a high BMI.
Furthermore, none of this evidence begins to unravel the lifestyles of these women.
Take me for example.
I would describe my experience as a fat women as being typical. I started being aware of food and dieting before puberty. I have been on upwards of 20 different diets, losing weight, then gaining even more weight. Spending all my time, energy and money focused on trying to become a socially acceptable size. I stopped eating fat, cut out the carbs, joined the gym, did a juice detox, tried the shakes, severely restricted my calories and portions, punished my body with exercise.
Let me make this clear. This is normal for a fat woman to go through. In fact I would go as far as to say that the majority of women in the western world experience this to some degree.
57% of women in the UK have been on a diet in the past year. (Source)
This is what’s fucked up our fertility. The unrealistic expectations placed on us to be a certain size, to look a certain way.
I am a very intelligent young(ish) woman. Yet I’ve spent my whole life obsessed with food
How can you account for that in a study? It’s not that women are fat, that’s that society has created a culture where these women have had to put their body through extreme circumstances to try and fit in.
Yet they still blame themselves. For not being able to lose weight.
Fat is not the problem.
The problem is that these women are forced to relive this cycle of restricting their calories and extreme exercising to lose weight to reach an arbitrary goal. Extreme calorie restriction and punishing exercise are yet two more stressors on the body – specifically designed to STOP FERTILITY, After all, if food was scarce or you had to run away from a lion everyday, it’s not an ideal time to have a baby.
And these women who are being denied IVF don’t feel like they can make a fuss.
They don’t feel like they deserve that help and support because society has brainwashed them into thinking that being fat is their fault.
That they are lazy, that they have no willpower, that they are stupid, if they can’t do something as simple as losing weight.
Let me repeat this. It’s not about the fat.
It’s about the belief that you can’t get pregnant because you are fat
It’s the years of yo-yo dieting that has fucked up your metabolism and hormones
It’s the continued belief that you need to punish your body with food and exercise in order to get pregnant
Instead of denying these women help, let’s support them in their health (not weight) goals so that they too can go on to have successful pregnancies.