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If you want to get pregnant in a bigger body, the chances that you’ve been told to “just lose weight” more than once are high!
Whether it’s your doctor, your family or your friends, each time someone brings up your weight in relation to your ability to become a parent, it stings.
Don’t they think you’ve tried that already?
Don’t they know that you’ve been living in this society your whole life? A society that is obsessed with us shrinking our bodies. A society where everywhere you turn, there are air-brushed images of thin, white women selling us the idea that we can be that happy when we look like them.
A society where, when you fail to meet these impossible expectations, YOU are the one that has failed. YOU are the one that was lazy/unmotivated/greedy/selfish/insert every insulting idea about fat people here.
So many of us have been on the yo-yo dieting rollercoaster our whole lives. We’ve lost weight, only to regain it back, often with a little extra for good measure.
But if you want to become a parent that badly, surely that motivation will be the one to make it stick? That magic ingredient you’ve been searching for, to finally be thin?
The problem is, that’s not how our bodies work. All of those diets you tried? You didn’t fail, they failed you. None of those diets has any evidence to support them working long term. Sure, they look good on paper. Short term weight loss is easy enough with enough restriction. But beyond 2-5 years? No diet has any evidence that the weight lost will be kept off for that long. In fact, the majority (over two-thirds) will regain.
But what about my health?
I know that’s what you’re asking because it’s the reason we’ve been fed over and over again for why we need to follow these weight loss plans in the first place.
More and more research is coming out that shows that health-promoting behaviors, i.e. what you do and can control, is what is having a positive effect on your health. And they have a positive impact on your health regardless of what your weight does. Even if you stay exactly the same weight, you can improve your health and well-being by creating healthy habits and supporting your mental and physical health in a nourishing way.
Here are some ideas of things you can control, that will have a positive impact on your health, wellbeing, and ultimately your fertility:
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Get enough good quality sleep
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Move your body in ways that feel good to you
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Get outside in the sunshine
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Repair your relationship with food (check out Intuitive Eating for more ideas on how to do this)
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Drink enough water to feel hydrated
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Spend time with people who light you up
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Set time aside for you and your favorite things to do
Those things are all well and good but what if there is more going on?
What if you need to access support from your doctor or reproductive specialist and they won’t see you until you’ve lost a certain amount of weight? What if you need IVF and you can’t access it because the clinic has arbitrary BMI restrictions?
That’s when it gets much harder. Most doctors still assume that fat is bad and that fat people are automatically unhealthy. That we sit on our couches all day eating fried food, drinking soda, and only moving to go to the bathroom.
You are worthy of appropriate and respectful care from your healthcare providers. If you see someone who won’t help you, here are a couple of ideas for what you can do:
1. Change doctors.
This isn’t possible for everyone. It depends on how you access healthcare, where you live, and so many other factors. If you can, find a doctor who is willing to look beyond your weight and treat you as an individual.
2. Advocate for yourself.
This takes emotional energy so please be as kind as you can through this process. If you feel you are in a position to, ask for the care that you need and be prepared to back up and argue your point of view with evidence. I’ve supported clients going through this and they’ve been able to change their doctor’s minds through the use of arguing that:
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Diets haven’t worked for them in the past and/or they have a disordered relationship with food
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There is a lot of evidence that shows that dieting is ineffective
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The time it would take them to lose the weight, has a much more negative impact on their fertility than any benefit from the weight loss
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There is a lot of research that supports the fact that IVF is effective for people with higher BMIs
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They are aware of the associated higher risks of being pregnant in a bigger body and consent to those risks.
What about the higher risks during pregnancy and birth?
But surely, if there are higher risks during pregnancy, why would you take those risks? Again, we are assuming that we have control around this. If diets don’t work, that means that we cannot control our weight and that we need to manage the increased risks associated with pregnancy. We don’t actively stop other populations of people who will likely have increased risks during pregnancy, so why are fat people different?
The risks during pregnancy are increased, but the risk is still often small. For example, 2.3% of people with a “normal” BMI will have gestational diabetes. 5.5% of people with a BMI of between 30-35 with have gestational diabetes. The risk is double, but still, 94% of people with that BMI will NOT get gestational diabetes.
Two key factors that are often not accounted for in these risk studies are weight cycling (the impact of your weight going up and down during dieting) and weight stigma (measurable and quantifiable discrimination that fat people face in our healthcare system). Both of these factors have been shown to increase the risks of many diseases.
It’s so important that all bodies are able to access fertility support without discrimination and judgment.
And above all, if you are in a bigger body and you are reading this right now, I want you to know that you are worthy of becoming a parent exactly as you are.
Nicola Salmon is a fat-positive and feminist fertility coach and author of “Fat and Fertile”. She advocates for change in how fat people are treated whilst accessing help with their fertility. Nicola supports fat people who want to get pregnant using her unique FAT+ve fertility framework to find their own version of health without diets, advocate for their bodies, relearn how to trust their body and believe in their ability to get pregnant in their current body. Find out more about Nicola on her website www.nicolasalmon.co.uk or on Instagram @fatpositivefertility.
