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Pharmacologic Treatment of Obesity in Reproductive Aged Women

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Abstract

Purpose of Review

This report will review existing literature on weight loss outcomes for various anti-obesity medications (AOMs) as well as their effects on human fertility, pregnancy, or breastfeeding.

Recent Findings

There is a paucity of research on the effects of AOMs on human pregnancy and fertility. The majority of AOMs are not recommended during pregnancy and breastfeeding due to known or unclear risks of harm to offspring.

Summary

As the prevalence of obesity rises, AOMs have proven to be effective tools for weight loss in the general adult population. When prescribing AOMs to reproductive-aged women, providers should consider both the cardiometabolic benefits of these medications and potential effects that AOMs might have on hormonal contraception, pregnancy, or breastfeeding. Animal studies in rats, rabbits, and monkeys have suggested teratogenic effects of several medications discussed in this report. However, a lack of data on the use of many AOMs during human pregnancy or lactation makes it difficult to comment on the safety of their use in these time periods. Some AOMs show promise in promoting fertility while others might decrease the efficacy of oral contraceptives, highlighting some of the special considerations that must be taken when prescribing AOMs to reproductive-aged women. More research into the risks and benefits of AOMs in the context of reproductive-aged women’s unique healthcare needs is an important step in improving this population’s access to effective treatments for obesity.

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Data Availability

Data sharing not applicable to this article as no datasets were generated or analysed during the current study.

Notes

  1. Overweight is commonly defined as BMI ≥ 25 kg/m2.

  2. STEP 7 is ongoing.

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Funding

Fatima Cody Stanford declares funding from the National Institutes of Health grants NIDDK U24 DK132733 and P30 DK040561. The rest of the authors have no declarations.

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Authors and Affiliations

  1. Department of Medicine, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA

    Akua Nuako

  2. Department of Sociology, Harvard University, Cambridge, MA, USA

    Lucy Tu

  3. Department of History of Science, Harvard University, Cambridge, MA, USA

    Lucy Tu

  4. Liver Research Center, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Karen J. Campoverde Reyes

  5. Metabolism and Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Karen J. Campoverde Reyes

  6. University Hospitals Cleveland Medical Center/Rainbow Babies and Children’s Hospital, Cleveland, OH, USA

    Shradha M. Chhabria

  7. Geisinger Commonwealth School of Medicine, Scranton, PA, USA

    Shradha M. Chhabria

  8. Division of Endocrinology, Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Fatima Cody Stanford

  9. Division of Endocrinology, Department of Pediatrics, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Fatima Cody Stanford

  10. Nutrition Obesity Research Center at Harvard (NORCH), MGH Weight Center, Massachusetts General Hospital, Boston, MA, 02114, USA

    Fatima Cody Stanford

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  1. Akua Nuako
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  2. Lucy Tu
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  3. Karen J. Campoverde Reyes
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  4. Shradha M. Chhabria
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  5. Fatima Cody Stanford
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Contributions

All authors contributed to the report’s conception and design. Shradha M. Chhabria, Karen J. Campoverde Reyes, Lucy Tu, and Akua Nuako performed the literature search and data analysis. Shradha M. Chhabria, Karen J. Campoverde Reyes, Lucy Tu, and Akua Nuako contributed to drafting the report. Akua Nuako, Lucy Tu, and Fatima Cody Stanford critically revised the final report.

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Correspondence to Akua Nuako.

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Nuako, A., Tu, L., Campoverde Reyes, K.J. et al. Pharmacologic Treatment of Obesity in Reproductive Aged Women. Curr Obstet Gynecol Rep 12, 138–146 (2023). https://doi.org/10.1007/s13669-023-00350-1

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