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Motherhood as Motivation: Helping Patients with a High BMI Reach a Healthy Pre-Conception Weight

by Beth Heller MS, RYT

 Until recent years, physicians worried about women not losing “baby weight,” and creeping up the Body Mass Index (BMI) with successive pregnancies.  Times have changed, though, and more women are entering childbearing years significantly overweight.  In fact, the issue of weight may be the single most important health issue facing U.S. women of childbearing age.   Besides the well-known health consequences of excess weight, overweight and obese women take a longer time to get pregnant.  Once pregnant these women have a greater number of adverse pregnancy outcomes including miscarriage and stillbirth.  Perhaps most troubling is the potential impact maternal weight could have on the health of future generations.  Children of moms with a BMI>30 may have been shown to have a higher risk of serious health conditions including obesity, asthma, Type 2 Diabetes and even autism.

First Line Therapy for Fertility (FLTF) is a new pre-conception weight loss program that uses a woman’s desire for a healthy pregnancy to motivate overweight women to attain a healthy weight for fertility and subsequent pregnancy.  The program, which teaches women a fertility-friendly Mediterranean-style diet, includes a one-on-one consultation with a Registered Dietitian.  Seven group follow-up sessions reinforce and teach lifestyle behaviors like stress reduction, grocery shopping and healthy exercise in preparation for pregnancy.  Weight loss on the FLTF program is designed to occur safely and is tracked using Bioelectrical Impedance Analysis (BIA) body composition measures to ensure lean mass is preserved.

Experts believe the adverse metabolic conditions associated with excess body weight (poor glycemic control, excess inflammation and disrupted hormone balance) are the root cause of the poor pregnancy and birth outcomes.  Unlike other diet programs, which focus primarily on calories and promote processed “diet foods,” FLTF emphasizes nourishing low-glycemic meals, increased intake of vegetables, fruits and healthy fats and the limiting of overly processed meals.

In my work with fertility and pregnancy patients, I find many women caught in a dieting roller coaster: weeks on extreme diet plans that bring short-term success followed by failure and weight re-gain as the new regimen becomes impossible to sustain.  Furthermore, these women are often distressed and distracted by other concerns, such as the all-too-common fertility problems that accompany excess weight.   Many have a history of pregnancy loss and miscarriage.  FLTF group sessions, and the common goal of motherhood, provide a peer support network for emotional support and improved compliance.

The cost of First Line Therapy for Fertility is just $210 and includes a one-on-one consult with a Registered Dietitian and seven RD led follow up sessions.  The program can also be done one-on-one or as a couple in two private sessions.  More information is available at 312-321-0004 or


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Aviram et al. Maternal obesity:  implications for pregnancy outcome and long-term risks-a link.  International Journal Gynaecology & Obstetrics (2011), 115:S6-10.

Krakowiak et al. Maternal metabolic conditions and risk for autism and other neurodevelopmental disorders.  Pediatrics (2012) April 9 epub.

Mann et al.  Medicare’s search for effective obesity treatments:  diets are not the answer. American Psychologist (2007), 62: pp 220 -233.

Lowe et al. Weight-loss maintenance 1, 2 and 5 years after successful completion of a weight-loss programme.  British Journal of Nutrition (2008), 99: pp 925-930.

Vujkovich et al. The preconception Mediterranean dietary pattern in couples undergoing in vitro fertilization/intracytoplasmic sperm injection treatment increases the chance of pregnancy.  Fertility & Sterility (2010), 94: pp 2096-101.