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Evidence-based research for weight management of the obese woman around the time of conception is not as simple as you think!

      More than one-third of women entering pregnancy are classified as obese. Maternal obesity not only makes becoming pregnant more difficult but also increases incidence of gestational diabetes, labor and delivery complications including cesarean sections and preterm birth, maternal and fetal death, hypertension, fetal congenital anomalies, and infants born large for gestational age. To mitigate the negative effects obesity may have on maternal and infant health, in a 2009 report titled “Weight Gain During Pregnancy: Reexamining the Guidelines,” the Institute of Medicine (IOM) put forth recommendations for women to enter pregnancy at a healthy weight and for those women affected by obesity to achieve weight loss before conception. Furthermore, in Committee Opinion number 600, The American College of Obstetricians and Gynecologists (ACOG) holds the physician responsible for recognizing the reproductive complications associated with obesity and providing appropriate, unbiased medical care focused on the medical, cultural, and social needs of each patient. If a physician does not have the resources or knowledge to properly care for patients with obesity, consultation with or referral to other healthcare professionals is endorsed by the College. The guidelines for obesity treatment established in 2013 by the American College of Cardiology and American Heart Association and endorsed by many others provide specific recommendations for the delivery of effective lifestyle modification programs, including minimum number for contacts, acceptable rates of weight loss, and delivery approaches to achieve a weight loss efficacy replicated in clinical trials. Although such interventions have been tested in the general population, evidence-based research is needed in specific populations, such as women and couples affected by obesity and trying to conceive.
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