The European Association for the Study of Obesity (EASO) has published a landmark position statement addressing care for women living with obesity throughout their reproductive life - from fertility and preconception to pregnancy, and the postpartum period.
Recognising obesity as a chronic, relapsing disease with significant biological and social implications, the statement moves beyond BMI as a sole diagnostic criterion. Following the EASO Framework published in Nature Medicine, https://easo.org/a-new-framework-for-the-diagnosis-staging-and-management-of-obesity-in-adults/ the statement strongly recommends using additional anthropometric measures, like waist-to-height ratio (WHtR), and advocates for advanced diagnostic tool use, such as Bioelectrical Impedance Vector Analysis (BIVA).
Key highlights from the statement include:
- Fertility and PCOS: Obesity can impair fertility, even in women with regular cycles. Modest weight loss (5–10%) over six months can restore ovulation. Women with PCOS may benefit from lifestyle changes, metformin, or GLP-1 receptor agonists.
- Preconception Care: Optimising weight before pregnancy improves outcomes. The statement calls for routine screening of comorbidities, folate supplementation, and contraception for women undertaking pharmacological or surgical obesity management.
- Pregnancy Guidance: Individualised gestational weight gain (GWG) recommendations are critical. EASO recommends GWG targets of 5–9 kg for women with pregestational obesity and encourages dietary and physical activity interventions.
- Safety During Pregnancy: Women with obesity face higher risks of gestational diabetes (GDM), preeclampsia, and fetal anomalies. The statement calls for tailored screening and increased fetal surveillance, especially during the third trimester.
- Postpartum and Breastfeeding Support: EASO urges structured postpartum weight counselling, contraception planning, and enhanced breastfeeding support, which may help women with obesity initiate and sustain breastfeeding.
- Medication and Surgery: The document underscores the lack of safety data on obesity medications during pregnancy and lactation. Metabolic bariatric surgery may be appropriate in selected cases, with a minimum delay of 12–18 months before conception.
By addressing gaps in guidance and championing a person-centred, evidence-based approach, EASO highlights the need for tailored care and ongoing support for women with obesity across their reproductive years.
Dr Andreea Ciudin, Co-chair of the EASO Obesity Management Working Group and Corresponding Author of the statement (Vall Hebron University Hospital, Barcelona) said
“Women living with obesity face unique health challenges throughout their reproductive life. This position statement is a call to provide person-centred, evidence-based care that supports women’s health and wellbeing at every stage.”
Read the full statement open access:
https://karger.com/ofa/article/doi/10.1159/000546449/929282/EASO-Position-Statement-Women-with-Obesity-across