The Impact of Obesity on Reproductive Health and Metabolism in Reproductive Age Females

Obesity is a highly prevalent chronic disease that impacts over 40% of reproductive-aged females. The pathophysiology of obesity is complex and can be understood simply as a chronic energy imbalance whereby caloric intake exceeds caloric expenditure with energy surplus stored in adipose tissue. Obesity may be categorized into degrees of severity as well as different phenotypes based on metabolic health and underlying pathophysiology. Obesity and excess adiposity have a significant impact on fertility and reproductive health with direct effects on the hypothalamic-pituitary-ovarian axis, the ovary/oocyte, and the endometrium. There are significant adverse pregnancy outcomes related to obesity and together with excess weight gain prior to, during, and after pregnancy, can alter lifelong risk for metabolically unhealthy obesity. Given the high-prevalence and pervasive impact of obesity on reproductive health, there is a need for better and individualized care for reproductive-aged females that considers obesity phenotype, underlying pathophysiology, and effective and sustainable interventions to treat obesity and manage weight gain prior to, during, and after pregnancy.