New Delhi, July 13, 2019: An alarming 50 percent rise in the number of overweight children, especially girls who grow into obese teens and adults, is one of the preventable but inevitable cause of infertility in women, according to the doctors at the Columbia Asia Hospital here.
Doctors suggest that serious lifestyle disorder such as a poor diet high on calorie and low on nutrition, peer pressure, and near-absence of physical activity are the primary reasons of abnormal body mass index (BMI) in teenaged girls. This often leads to chronic health conditions such as polycystic ovary disease (PCOD) or Stein-Leventhal syndrome. This in turn contributes to anovulation (the ovaries do not release an oocyte during a menstrual cycle resulting in no ovulation causing irregular menstrual cycles or amenorrhea) and other menstrual irregularities, reduced conception rate, and a reduced response to fertility treatment.
“The ideal weight for a girl between 6 and 12 years should be 19.2 – 38.5 kg and between 12 and 17 years, it should be 38.7 – 53. 0kg. However, many of the young girls who have attained puberty come to us are overweight – within the range of 56 – 78kg. Adult women who come to us with issues such as irregular periods or PCOD also show a consistent trend of carrying extra weight as teenagers. Most obese women with infertility and signs or symptoms associated with androgen excess are affected by polycystic ovarian syndrome (PCOS). Many of these women were able to reduce weight and conceive and complete their pregnancy successfully, but not all,” says Dr. Neera Bhan, Obstetrics and Gynecology Columbia Asia Hospital, Ghaziabad.
Researchers have shown a close relationship between energy metabolism, nutritional state and reproductive physiology and disorders or alterations in the nutritional state (obesity, malnutrition, anorexia nervosa, etc.) and metabolic disturbances can disrupt the complex interplay of hormones essential for fertility, such as gonadotropins and gonadal. Studies in the past have shown how early-onset obesity is associated with early puberty and abnormal maturation of the activities of hypothalamus, pituitary gland, and ovary; these changes may lead to the development of PCOS.
“More than anything else, obesity, especially abnormal amount of abdominal fat, hampers the natural physiological mechanism of a girl’s body, irrespective of her willingness to have a child. That a preventable disorder such as obesity is causing havoc in the lives of our girls is a cause of serious concern. Weight loss improves menstrual regularity, ovulation and fertility, and should be promoted as the initial treatment option for obese girls at risk of infertility: Usually, only 8 to 10 percent weight loss is required. Lifestyle modifications are the best way to achieve and sustain weight loss, including regulated dieting, regular exercise, cognitive behavior therapy and a supportive group environment,” says, Dr. Neera Bhan, Obstetrics and Gynecology Columbia Asia Hospital, Ghaziabad.
Managing Obesity in Young Girls and Teenagers: · Sensible diet and changed eating habits · Behavior modification, reduction of stress, well being · Effective physical activity programme sustainable for the long term · Avoiding ‘crash diets’ and short-term weight loss · Stopping smoking and reducing alcohol consumption · Avoiding aggressive surgical approaches · Adopting the weight loss programme to meet individual needs · Social support by physician, family, spouse and peers · Long-term observation, monitoring and encouragement of patients who have successfully lost weight
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