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

[Helpneeded719]

Hello everyone, name change for this post as it is very personal.
I am 34 years old, I have had 2 miscarraiges - one chemical at 5 weeks and one mmc at 9/10 weeks there had been a heartbeat previous to the loss, I sadly have no living children.

Myself and DH are DESPERATE for a baby, all blood work came back as normal in regard to the pregnancy losses, we didnt do any further investigations. I dont have any underlying health conditions, however I am extremely unfit and morbidly obese (BMI of 46 I think).

I am only just 5 foot but weigh 17 stone and honestly eating what are "regular" portions of food for most people make me gain weight, I have to starve to get to a healthy weight, I then struggle to keep it off. Have a generally ok diet each loads of vegetables, fruit etc. But weight just does not come off easily for me at all, I do have quite a large appetite and I do struggle with emotional/boredom eating too. My doctor has said the whole eat less move more just simply does not work for people with genetic predisposition to being heavier etc. So its just not that simple for me unfortunately (trust me I have tried)

My dilemma is do I try to get maybe 2 stone off over the next 3 months by myself via eating a banana, a healthy oat cereal bar and a smaller portion of a homemade, healthy & nutritious dinner every day - will be a struggle to stick to it but this is all I can eat to actually loose weight, and then try again for a baby ASAP, BMI will still be well into the severely obese category

or do we take a break from trying for 9 months, I start on ozempic for 6 months, loose weight, stop for 3 months as recommended and then TTC again when at a healthier weight? This option seems so tough mentally as we are so desperate to have a child of our own. But I need to think about what is best for both my own health and that of a future pregnancy.

How much of a struggle would pregnancy be for me at my current weight? 5 foot and 17 stone, I do have hip pain and am very out of breath walking up a stairs. What are the chances my weight contributed to my miscarraiges?
Other side of the story is waiting another 9 months at my age to TTC ill be 35/36 when baby is born.

Really struggling with the decision, my GP hasn't brought up my weight and just said I shouldn't find reasons to blame myself for the miscarraiges when I asked.
Has anyone any advice? What is likely to be worse being obese or being older when TTC?
I had no issue falling pregnant but both pregnancies have sadly ended in loss.

Thank you if you've gotten this far xx I am terribly ashamed about my weight and fitness levels, it is something that causes me a great deal of emotional upset and shame. But I have my reasons of why Im here so I really dont need any lectures or shaming, please, as I really have beaten myself up enough over it for us all,
Thank you x

I was speaking in regard to previous weight loss attempts when I said this...I would try to eat eggs for breakfast which meant eating at 5am, when loosing weight I would eat my first meal (a banana) at 10am as explained above. So would be fasting from 6.30/7pm to 10am, if it dont eat at the 10am break at work the next chance would be 2pm so I have to eat at 10am. 6.30pm is the earliest I can have dinner unfortunately as with work I dont have the flexibility to eat while on the job so my breaks are 10am, 2pm and 6.30pm.
Its not that i never go to bed hungry, I just dont go with hunger pains/grumbling stomach as I eat at 6.30 and get to bed around 10/10.30, I was advised not to go to bed hungry by a nutritionist.
What has worked for me with weight loss before was :
Banana 10am
Homemade oat bar 2pm
Dinner of salmon/chicken/steak, baked potato, egg and vegetables 6.30pm
Kiwi 7pm

This works for me but I am hungry for most of the day.
my work situation is unusual in that i dont have access to heat food in the morning, 6.30pm is the only time I have access to a kitchen to heat food so any other time of day needs to be cold food

What I tend to eat when not actively trying to loose weight which leads to me gaining weight
10am - oat cereal bar or overnight oats
2pm - wrap with chicken, cheese and salad
6.30pm- dinner of stir fry w rice, chicken curry w rice, pasta dish, lasagne or similar.
8pm - homemade biscuits (2) and a cup of tea

Ive probably made the post confusing, basically I know what works for me weight loss wise but it means I'm hungry as I have to eat very little (for my appetite)..which leads to my question about ozempic or similar GLP 1

The baking at home is obviously only when we are not actively trying to loose weight (particularly through periods of grief - not just pregnancy loss) that we are both guilty of emotional eating etc. My main issue is to loose weight I have to severely restrict my food (for me) and it leaves me hungry as I have a large appetite so basically glp 1 would help to combat this and aid in weight loss. I dont loose weight easily by upping steps and cutting out treats that just does not work for me - i wish it did as then it would be a lot easier.

I think that WLI have loads of health benefits, and are absolutely worth trying to see if you can get your health under control.
I think you would be eligible on the NHS too surely with your BMI, so to me, that's got to be worth at least trialling it.
If you don't get on with it, you could stop.

Focusing on your health sounds sensible. Mounjaro has been life changing for me. I have lost nearly 4 stone in 10 months. I recommend it wholeheartedly - I have struggled with my weight for years before this. I get it privately and it has been an expense, but without it I would still be in the situation I was in 10 months ago. Mounjaro has also helped me with joint pain, and this is something I’ve heard from others too.

Thank you to everyone for all of the feedback & advice and to so many for sharing their stories.
I appreciate them all so much and my head is much clearer now after reading them all.
I am devastated to have to put off TTC for a while but its clear I need to focus on weight loss and health first, I will speak to my GP on what the best way to approach this is via GLP 1 or restricted diet where I am hungry (just afraid ill struggle to stick to this)

To add in I am actively looking to change jobs, and would absolutely not be staying in this role/industry even after having kids, I always thoroughly enjoyed my job but since having the miscarraiges I have lost all interest and personally see what I am doing as a pointless task. I have a degree in another industry that is a more rewarding career route and my long term plan was to move to that industry anyway so that was my plan.

Thank you again everyone.

Is the advice to stop the WLI prior to getting pregnant and not be on them during pregnancy?

If so, I think the sad truth is you would mostly likely regain a large proportion of what you lost when you come off them. Weight gain after coming off can be rapid for many people.

I really hope you are able to have a healthy pregnancy, then I would recommend getting on mounjaro so you can be healthy and have the best chance of being around for your child for a long time ❤️

Good luck with it all @Helpneeded719 . It’s worth being aware though that despite your BMI of 46 you wouldn’t be eligible for Mounjaro via your NHS GP as you also need 4 out of 5 specific weight related health conditions (T2 diabetes, high cholesterol, high BP, heart disease, obstructive sleep apnea).

Your GP can refer you to the specialist weight loss service in your area, which will be things like coaching apps, gym membership, dietician advice etc. if you don’t lose significant weight after a decent length of time on that, then they would either refer you for bariatric surgery or possibly offer Wegovy depending on your NHS area. That process is likely to be 1 to 2 years given waiting lists and so on.

Can you try to get used to ‘sitting’ with a degree of hunger pangs if you want to eat less and lose weight. Michael Moseley has some useful advice in the Fast 800.

But ultimately you need to wean yourself off refined carbs and sugar. Replace rice, pasta, potatoes with vegetables and limited amounts of quinoa and lentils. Stop baking - eat fruit instead.

Check out Dr Becky Gillaspy’s videos on YouTube.

The Blood Sugar Solution by Dr Mark Hyman is extremely informative and readable, with some excellent advice on reducing dependence on carbs and sugar.

Lucy Wyndham Read’s 4-7 minute workouts are very good for days when you don’t have time to do a Pilates session.

i understand that all this may seem overwhelming, but if you tackle it at a slow and steady pace you CAN get there.

The first challenge is the pregnancy itself not the child rearing aspect. Firstly to reduce the chance of loss (although most are overwhelmingly related to chromosomal abnormality, higher BMI does increase the chance of normal embryo loss) and then to reduce the chance of major placenta problems, gestational diabetes, early labour, stillbirth, congential anomalies etc.

@SilenceInside given the high potential benefit I think it's worth just paying privately.

@FirstdatesFred better to regain from a huge headstart!

OP seems all set on a positive plan.

So sorry for your losses OP.

Yes, given your weight I would try to lose a significant amount before TTC. However I would try Mounjaro rather than Ozempic/Wegovy as it is more effective for most people.

I lost over five stone in a year going from 13:8 to 8:4. It’s been life changing for me and my underlying chronic health problems are minimised now.

Good luck, whatever you decide to do. 💐

Totally agree @sirensong, indeed that’s what I have been doing for the past 18 months or so myself. I think it’s useful for @Helpneeded719 to be aware of what an NHS GP is able to offer and what she would be able to access via that route.

You will massively improve your quality of life and longevity if you go onto Ozempic. Do it! I see a professor of endocrinology for various issues and she says these medications are life-changing for many people.

There is no willpower in the world that can help you lose weight if your body responds to it by panicking you into eating. Go for it!

Sorry for your losses op. I don’t say this lightly, but I think you’ll feel better all around for shifting some weight. My BMI was about 30 when I gave birth at the end of 2024 and not only did it regularly crop up, it also is considered a risk factor. I had gained weight through fertility treatment and felt terrible about it. I am about 20kgs lighter now and feel so much better, feel like a better more able parent as well as better physically. In the grand scheme of life, waiting 9 months isn’t a huge amount of time for the benefits you’ll get xx

I can't speak from experience with obesity as I had the opposite problem (being slightly underweight and suffering 2 HG pregnancies) but I think starting a family being your healthiest self be is a gift to yourself and your future child. ❤️For me this meant gaining weight beforehand as I spent the first 4-5 months vomiting over 6x a day and hardly eating anything😢. So it was good that I was prepared the 2nd time around and made sure I could stand to lose a couple of lbs.

Pregnancy is hard on your body and so is new motherhood, so if you can find a way to get healthier it is definitely worth the wait.
Your fertility doesn't just plummet after 35; the decline in fertility is gradual. If you can find out if you/your DH's fertility is ok otherwise I would strongly advise giving yourself more time to get in shape to prevent your system from being overloaded.
Maybe you can book a pre conception consult with a maternal-fetal medicine specialist that can help decide the best course of action? I was 35-36 when trying for a second (as had high risk pregnancy before so took a long time to work up the guts to try again) and I remember her laughing at my worry that 35 was old... I think that being unfit (so either over or underweight!) poses a bigger risk in pregnancy than being over 35, but this is something a MFM specialist will know more about as they experience associated complications on the daily.

Good luck OP! 🍀

5’6. Was 17st 3 and struggling due to disability as well. Went on Wegovy for a year and lost over 3 stone. Came off for three months before TTC and am so grateful I started my pregnancy at a lower weight.

If you take a weight loss injection though, please please please focus on high protein intake. This is what will help you retain muscle and metabolism, which are vital for not putting weight back on easily once you come off.
I found protein yoghurt pouches perfect because you can have just a few mouthfuls and stop when you’re satiated to get rid of hunger pains, without sitting down and eating a whole portion of food you’ve made. Which is an easy trap to fall into, even if it’s a healthy meal.

Gallstones can be caused by crash dieting which is why they are a contraindication with the WLI. In addition there is a very small risk of pancreatitis which has been fatal for 17 wli users. So tbh I would try absolutely everything else before wli.
You are not tall, so normal food portions will be too big, that would be my starting point.

OP, currently there are risks associated with Ozempic and pregnancy, as well as with several high-payout lawsuits for patient injuries which are numbering in the thousands. Just look through the links below and be very careful when you're trying to plan on how to proceed with making your plans for a child if you put this drug in your plans. The best of luck to you.

https://www.universityhealth.com/blog/ozempic-and-fertility

https://trulaw.com/ozempic-lawsuit/ozempic-lawsuit-settlement-amounts/