Overweight, as defined by the World Health Organization, is a body mass index (BMI, ratio of height to weight) of over 25. A BMI of over 30 is considered obese.
According to a data brief released in 2017 by the National Center for Health Statistics Data Brief, about 2 in 5 adults and 1 in 5 children and adolescents in the United States are obese and many others are overweight. Overweight and obesity are linked to many serious health problems, including type 2 diabetes, heart disease, stroke, and some types of cancer. Fertility, in both men and women, can also be negatively affected by excess weight.
Adipose tissue (fatty tissue) has an important role in the body: it provides insulation, absorbs shocks for the internal organs, stores fats to be released as energy in the shortage of glucose, and plays a significant role in sexual maturation and fertility. And although adipose tissue is necessary for reproductive function and normal development, excessive adipose tissue causes some reproductive disturbances.
Overweight and fertility
The risk of infertility has been shown to be threefold higher in obese than in non-obese women, and several studies have demonstrated that obese females need longer time to pregnancy. This is mainly due to the fact that extra adipose tissue interferes with ovarian function and endometrium health. A study published in 2007 by Fertility and Sterility titled “Obesity and poor reproductive outcome: the potential role of the endometrium”, concluded that “excess weight exerts an extraovarian detrimental effect, and that its correction could improve the reproductive outcome in overweight and obese patients”.
What seems to be at the center of how excess weight affects fertility is a hormone called leptin. This hormone is produced primarily by the adipose tissue, and the amount of serum leptin is directly proportional to the amount of adipose tissue the body has - the more body fat, the more leptin. A study published in 2013 by the Journal of Applied Pharmaceutical Science, titled “Relation of Serum Leptin with sex Hormones of obese Infertile Men and Women” concluded that:
“Elevated levels of leptin (hyperleptinemia) is associated with infertility in men and women."
As mentioned earlier, not enough adipose tissue could be almost as disruptive as too much – the same is true for leptin. A study published in 2008 by the Saudi Medical Journal concluded that “decreased leptin levels disrupt the neuroendocrine regulation of reproduction. At the same time, high leptin levels are likely to exert a negative influence on the normal ovarian function and on fertilization that is required for the development of the embryo”. In other words, not enough weight (BMI < 18) or too much weigh (BMI > 25) can both impair fertility.
Overweight and male fertility
Male fertility is also affected by extra weight. It has been shown that leptin levels correlate with increased instances of infertility, decreased testosterone, and increased rates of erectile dysfunction. A review published in 2015 by Reproductive Biomedicine Online titled “Paternal obesity negatively affects male fertility and assisted reproduction outcomes: a systematic review and meta-analysis” concluded by saying that:
“Male obesity is associated with reduced reproductive potential."
IVF and obesity
A review published in 2011 by Reproductive Biomedicine Online titled “Effect of body mass index on IVF treatment outcome: an updated systematic review and meta-analysis” showed that women who are overweight or obese have a poorer outcome following IVF treatment compared with women with normal BMI. The review also demonstrated that a raised BMI is associated with a significantly reduced live-birth rate and an increased miscarriage rate after an IVF cycle.
“The current review and meta-analysis is able to clearly demonstrate that raised BMI is associated with a significantly reduced live-birth rate and increased miscarriage rate after IVF treatment."
Acupuncture and obesity
There have been multiple studies in the past 2 decades looking at how effective acupuncture is with regards to obesity. One of these studies, a systematic review and meta-analysis, looked at 21 studies that evaluated the effectiveness of acupuncture in obesity. After looking at 1,389 participants, the study concluded that “acupuncture is an effective treatment for obesity and inferred that neuroendocrine regulation might be involved”. While acupuncture can help regulate some of the imbalances that are contributing to obesity, a life-style change that includes diet and exercise is a must for anyone that is serious about losing weight. Another systematic review and meta-analysis that looked at 27 trials involving 2,219 participants concluded that “the effect of acupuncture on obesity may be maximized when auricular and manual acupuncture treatments are combined with lifestyle modification”. This lifestyle modification includes a diet that is free from inflammation-causing foods such as sugar, dairy products and meat; focusing on mainly a whole foods, plant-based diet. It also includes a routine of regular exercise.
“We concluded that acupuncture is an effective treatment for obesity and inferred that neuroendocrine regulation might be involved."
Anyone that is overweight or obese will tell you that walking 20 minutes every day, or doing any kind of exercise is extremely difficult. The Journal of Clinical Endocrinology & Metabolism published a paper in 2020 titled “Electroacupuncture Mimics Exercise-Induced Changes in Skeletal Muscle Gene Expression in Women With Polycystic Ovary Syndrome” where they concluded that: “Our findings provide evidence that electroacupuncture normalizes gene expression in skeletal muscle in a manner similar to acute exercise. Electroacupuncture might therefore be a useful way of assisting those who have difficulties performing exercise”. The needles were electrically stimulated for 45 minutes in acupuncture points around the lower abdomen. This type of acupuncture could help transition obese patients towards actual exercise.
“Our findings provide evidence that electroacupuncture normalizes gene expression in skeletal muscle in a manner similar to acute exercise. Electroacupuncture might therefore be a useful way of assisting those who have difficulties performing exercise"
A study to examine the effectiveness of acupuncture on body weight loss, routine laboratory tests and pro-inflammatory markers, published in 2015 by the Open Access Macedonian Journal of Medicine Sciences concluded that “Body acupuncture in combination with diet restriction was found to be effective for weight loss and also reduction of the inflammatory reactions. Acupuncture could be used as a synergistic treatment option for obesity control”. The same study mentions that acupuncture appears to be able to improve mood by increasing the release of neurotransmitters, and suppress appetite by the serotonin and endorphin-induced decreases in stress and depression, whereas this effect was not seen by exercise and diet.
It has been shown by several studies that acupuncture is an effective modality to treat obesity. In addition to acupuncture, the overweight patient should also follow a whole foods plant-based diet as well as get regular exercise. An overweight person (BMI > 25) that is trying to get pregnant can increase the chances of getting pregnant by doing acupuncture. Acupuncture is not only going to increase blood flow in all reproductive organs, but also help reduce some of the excess weight, as well as helping the person to relax and improve their mood.