Hello, I’m Eli Reshef, I am a reproductive
specialist and also serve as the medical director of INTEGRIS Bennett Fertility Institute. I
evaluate and treat infertility, miscarriages, abnormal hormones, including polycystic ovarian
syndrome, endometriosis, and fibroids. Let’s talk about obesity and reproduction. In my
practice, weight issues, including obesity, are very, very common. When I first see a
patient with weight problems, my assumption is that she is already very, very aware of
her weight as a health issue. Many of my overweight patients have struggle with this physical
matter for years and have tried numerous times and ways to lose weight. They have been lectured
to, judged and often ridiculed by friends, family, strangers and even medical personnel.
What these patients really need first is the reassurance that they should not expect a
stern lecture or sermon by me about this issue in every visit and should not dread coming
to see me because of a patronizing or condescending attitude. My job, as a caring physician, is
to educate these patients about reasonable weight loss expectations and the overall health
consequences of obesity, especially in pregnancy. Unless my overweight patient is physically
sick, for example with uncontrolled diabetes or high blood pressure or heart problems,
I do not deny her reproductive treatment. I emphasize that the improvement in general
health by losing weight is likely to increase her chance to get pregnant, reduce the chance
of miscarriages and reduce complications in pregnancy. One of the most important statements
to my overweight patients, as a father myself, is that they should look forward, not only
to have a baby, but a healthy baby. They should also look forward to being health effective
parents that should see their children through important milestones in their lives, including
graduations, marriages and grandchildren. The time to alert people about weight issues
is when they’re still young, when health problems can still be reversed or prevented. This is
usually when they come to see me. At a relatively young age when reproduction is their main
concern. My job is to provide the big picture regarding health, not just address reproduction.
A gentle approach to this sensitive problem is often more effective than a stern lecture.
And if the patient chooses to take charge of her health, I am one of her biggest cheerleaders.