Severely obese, 2 miscarraiges, should I go on ozempic before TTC again?

@Helpneeded719
Why do you have to work 13 hours a day and how will you combine that level of work with children?

Have you ever kept a food diary?

Thyroid - optimal level is a TSH of 2, especially in pregnancy. GP's are poor at optimal thyroid, dietary advice and pregnancy. Please see an endocrinologist for advice.

Miscarriage: I had 5 pgs that reached the 2nd trimester, 3 the third. I lost count of the early ones - which 30 odd years ago we shrugged over and viewed potentially as a late period. I have two DC. I was 30s and a normal weight. However, there is more and more research indicating links with thyroid and sub-optimal pg experiences.

I'm 5'6" and to keep my weight at 11stone (was 9ish in my 30s), I eat no refined carbs, no sugar, little red meat, no wheat, no saturated fats. Breakfast is typically 2 tbs greek yoghurt, 6 nuts, 1/2tbs all bran, half a dozen raspberries, tbs blueberries. Lunch is typically a salad of lettuce, pepper, cu, tomato with a little virgin olive and wine vinegar, half a can of tuna and a tbs cottage cheese. Dinner is typically chicken or fish with the equiv of 6 new potatoes, salad or veg. Daily fruit: 1 apple, 2 satsumas, small lunch of grapes. Glass of wine (or 2) Friday and Saturday. If I want to lose one pound I have to cut out breakfast, lunch or dinnernfor two or three days and have no wine.

I think you need to be very very honest with yourself about what is going in and get yiur thyroid sorted out.

@Helpneeded719 Insulin resistance can definitely make it harder to lose weight but nobody is destined to never be able to. Because excess adipose cells are hormonally active they cause a circular problem, in terms of further driving IR, but it's possible to disrupt.

Re hunger pangs - it's completely normal to have to go go through several days of light cramps when transitioning away a from high carb diet, as it's your stomach physically shrinking. I get this after eg a big takeaway or post christmas splurge. But they are a good thing and pass. There are also a few days of frequent urination as your body releases retained water/ bloating.

I think the injections for a few months would give a boost to morale, because you'd start to see results fast and not feel effort was all for nothing. They'd also get you used to smaller portions. You could alongside consider following an online weights or stretching tutorial on youtube or even just dancing around your house for 30 minutes - anything to help the joint pain/ breathlessness you've described, as pregnancy is a major heart strain.

Longer term, if you can find one or two healthy meals you love it will never be a chore to eat them. Or just try to cut anything like biscuits during the day, which are a killer for blood sugar, drink a lot of water and then eat your usual but make half the plate different coloured vegetables or salad.

The ‘stomach grumbles’ are a good sign that your body is adjusting to the reduction in food intake - try to see it as an indication that you’re losing some weight as opposed to a sign that you need to eat more.
Out of interest, is your DH also overweight? If so, is he dieting with you? If he’s not overweight, what’s his take on you trying to lose weight? Is he encouraging, or does he unconsciously sabotage your efforts?
Ultimately, being lighter will reduce strain on your body, so your hip pain will lessen. It will also mean you’d be more actively engaged with your baby, be less likely to develop illnesses linked to obesity and generally fell better all round. In your position I would use WLJs to lose weight then attempt to conceive once you’re down to a more healthy weight.

Yes.
It's not just about being able to conceive a pregnancy, its about having a healthy pregnancy, a safe delivery and a postnatal period where you can be healthy and recover well enough to care for a newborn.
It is also about when your child gets older and being able to give them an active childhood with a mum that can run after them. Speaking from experience here, as someone who's mum died when I was in childhood from obesity complications, you want to be around to see them grow up.

I’m not an expert but wonder whether cutting out all added sugars and refined carbs might be the way to go. Instead eat lots of vegetables (including root vegetables roasted in healthy fat , which are very filling and full of fibre, some lean protein and dairy (especially LIDL’s full fat Greek yoghurt), and fruit.

However, I’d also try and find a specialist nutritionist - someone who is very experienced in dealing with unusual cases like yours.

Given your extremely long working/commuting day, is there any way you could find a less challenging job, or at least one that is closer to home? Or move closer to work?

ETA just saw your update re. Yoghurt - maybe try cottage cheese instead?
re. Eggs for breakfast making you nauseous - could you perhaps delay breakfast until you get to work and have some boiled eggs and fruit

If it were me, yes I’d take a year off to focus on getting healthy. Mounjaro has been life changing for me and I’ve lost 3 stone (another 2 to go). If you go that route, make sure your contraception is bullet proof as there’s clear warnings on weight loss drugs that you shouldn’t take them if you’re trying to conceive.

So sorry to hear your story, it must be very painful.

Gently, I would remind you that your GP is not a specialist in this area and their advice may not be helpful here about it being harder for some people to lose weight. I’m not saying this is completely untrue but it removes some sense of agency and hope. Oat bar and a banana is a terrible choice for the first part of the day and will lead to you feeling very hungry, it is high sugar and will leave you wanting more very quickly. I know you have done it previously but you need to religiously track your calories, protein and fibre.

Consider having a look at the glucose goddess and reading/watching some guidance from Tim Spector about ultra processed foods. There is currently a tv programme available on C4 ‘what not to eat’ and one by Joe Wicks about UPFs.

I have had problem ttc and all four of my children were conceived when I was dieting and restricting calories to lose weight, so anecdotally it can make a huge difference.

Hope that you get your baby this year.

So sorry to hear about your miscarriages.

I would definitely have further testing for you and your DH as you don’t want to assume it’s you and not have your DH try to improve things if it’s him. I would also put ttc on the back burner to try and get into a healthy weight but that won’t be within 6 months if you lose at a sensible rate. If you lose too quickly, you will lose muscle which means you’ll pile it back on and more in no time. You’re also at higher risk of gallstones as someone else said. You don’t want to lose more than a couple of pounds per week after the first few weeks when you may lose a bit more. In this time, I’d also try to exercise to improve your lung function and lift some weights to mitigate muscle loss.

If you don’t get back into a healthy weight and get some level of fitness, as soon as you’re pregnant, it will pile back on and that does put both of you at higher risk.

I personally think the risk of waiting a year or two is lower than not addressing the health issues. As I said, use the time to both have tests so it’s not wasted time at all. Make sure your DH is eating healthily even if he’s a healthy weight (and to lose weight with you if not). It’ll make his sperm healthier.

Weight loss and fitness will make pregnancy, birth and afterwards so much easier. Good luck x

A banana, oat cereal bar and dinner isn’t going to help you lose weight for a start OP.

you need to cut down on carbs and focus on lean protein and healthy fats with clean carbs. Work out your macros and use my fitness pal and weigh your food.

it’s a big dedication and may involve you having some very honest conversations with yourself but much healthier then WLI

Echoing what has been said about getting some blood tests done, particularly HbA1C and thyroid. It is not normal to need to eat a tiny number of calories to lose weight. At your current weight, height, age and assuming a sedentary lifestyle you should be able to eat around 2000 calories a day and stay the same weight, so 1500 calories a day should see a steady loss of 1-2 lbs a week, add in some basic exercise like a brisk 20 min walk 3 times a week and you should definitely lose weight, if you don’t lose weight eating less than that then there is something not working quite right.

I was diagnosed with PCOS but told no treatment I just needed to lose weight - eat less, move more. That didn’t really work. I was able to lose weight but only by starving myself, eating no carbs, doing loads of exercise and feeling hungry and in pain constantly. I did manage to lose 10% bodyweight that way though, and I got pregnant, and I got gestational diabetes. Was put on insulin during pregnancy and the weight fell off. I was 2 stone lighter at the end of my pregnancy than the beginning. As soon as I had the baby they stopped my insulin telling me that giving birth cured my GD and I was never tested or treated for anything again, just kept getting told all my problems were due to being fat and I needed to sort myself out.

2024 I was diagnosed with T2 diabetes after buying myself a continuous glucose monitor and presenting the incredibly high sugar readings to medical professionals.

At that point the diabetes team started prescribing me insulin and metformin which didn’t work so moved on to Mounjaro which was miraculous, blood sugar levels fell to normal range within weeks and the weight fell off. I’m now 9 stone lighter, in the healthy BMI range for the first time since primary school, BP is normal, cholesterol is normal, muscles/joints don’t ache constantly and I’m wearing size 10/12 clothes.

I’m very happy to answer any questions you have - it was around 50 for both, possibly late 40s with the first but there wouldn’t be much in it.

I started WLI seven weeks ago and have lost nearly 3st 🙏

@Helpneeded719 those injections really help some people to lose weight fast and at 34 you can afford to take some time out of TTC.

Even though most women with a higher BMI will probably be ok it isn't worth the extra risks in terms of pregnancy complications, loss and birth defects if you have the opportunity to get healthy first.

OP, not much specific advice but I’d recommend this book for the shame you feel
about being overweight: Enough
yes it talks a lot about wli but at the core of it is the fact that obesity is not your fault, and the shame around it. Best of luck x

With DC1 I had a straight forward pregnancy. He always measured a little small which is common with overweight mothers. He didn’t want to come out so I was induced, had an epidural relatively early on, pain free from there, one stitch after he was born.

DC2 had in uterine growth restriction (he stopped growing). I developed pre eclampsia (which I was told was uncommon if you’ve not had it first time around). I was hospitalised for two weeks before he was born, he was induced at 35 weeks for both our safety (they couldn’t get my blood pressure under control), early epidural again, and a couple of near misses with an EMCS, he was born weighing 1.7kg. It was extremely scary (although again very little pain thanks to the epidural) and he’s perfect now but I still have blood pressure issues (which I’d never had before).

My weight definitely increased my risk of getting pre eclampsia and I also had to inject myself with blood thinners daily during both pregnancies because of the increased risk of blood clots.

I also had some pelvic girdle pain (hip pain) with both pregnancies but it was manageable.

I don’t mean to scare you but in your shoes I’d definitely try and lose some weight first. WLI have been really revolutionary for me.

I strongly endorse @LittleLemonPie ‘s suggestion of working out to Heather Robertson’s videos with dumbbells. She is excellent! I would just say though, if you’re new to exercise and weight training you may want to start with a lower weight, say 2.5 or 3 kg.

To help improve your general fitness, check out Lucy Wyndham Read, also on YouTube. She has tons of very short and easy workouts, including some sit-down exercises for people who may struggle exercising standing up.

Walking is always good. You can enhance the effect significantly by wearing a weighted vest (3-5 kg), and/or wrist and ankle weights.

@Helpneeded719 I’m sorry you feel you’ve lost yourself, you sound like you need a massive hug 🤗
Are you able to talk with your partner about all your feelings etc?
I felt like that too a few years ago. If you do decide to try maybe some meditation that can help mentally just even a little bit it’s not a quick fix unfortunately just daily habits.

Also some vitamins I took-
CQ10- good for egg health
Lions main- helps with focus and mental health
Methylated folic acid- ( folic acid the drs give is a synthetic version that only about half of us can absorb, methylated is pure form)
Collegen
British supplements are clean so they are a good website to buy from.
Of course research all them yourself and see what you think.

A break from ttc will hopefully be helpful for you ❤️ I wish you the very best for your future ❤️

I lost 15 kilos in 4 months. It was really fast, no doubt about it - way too fast, I learned.

I think it was the weight loss that triggered the gallstones. It disrupts your body's usual process of producing bile and then everything slows down until stones form.

I am definitely not saying this is common or is a reason not to tackle your weight generally or before becoming pregnant. I just think it's worth getting good advice on how to lose weight promptly but not dangerously fast.