FIT-PLESE randomised controlled trial finds weight loss does not help pregnancy chances

A randomized study of 379 women living with obesity and unexplained infertility has concluded that intensive lifestyle changes resulting in weight loss did not result in better chances of pregnancy and healthy births compared to increasing physical activity without weight loss. The findings were reported in the paperm ‘Effects of preconception lifestyle intervention in infertile women with obesity: The FIT-PLESE randomized controlled trial’, published in PLOS Medicine.

"We have known for decades that obese women often have difficulty getting pregnant," said researcher Dr Daniel J Haisenleder, of the University of Virginia School of Medicine's Center for Research in Reproduction. "For this reason, many physicians advise weight loss prior to conception. However, there are few studies that have addressed the issue comparing a healthy lifestyle i.e., exercise vs. exercise plus weight loss."


The FIT-PLESE study, conducted at nine academic medical centres across in the US, divided participants into two groups: Half the women dieted intensely using meal replacements, medications and increased physical activity. The other half simply increased their physical activity without trying to lose weight. After completing the programmes, both groups received three rounds of standard infertility treatments.


Women in the weight-loss programme ended up losing, on average, 7% of their body weight, while participants in the exercise-only group typically maintained their weights. But, in the end, there were no significant differences between the two groups in terms of the frequency of healthy births. In total, 23 of the 188 women who completed the 16-week intensive weight-loss program ended up giving birth; among the 191 who completed the exercise-only programme, 29 gave birth.


The intensive dieting programme did offer health benefits for the women who completed it, however. In addition to dropping pounds, they saw a major decrease in metabolic syndrome, a cluster of conditions that increase the risk for serious health problems such as diabetes, stroke and heart disease.


Based on their findings, Haisenleder and his collaborators conclude that the weight-loss programme did not make women more fertile or improve birth outcomes compared with simply exercising. They note the health benefits of weight loss may not translate into better odds of getting pregnant.

"Weight loss improved metabolic health in these subjects. Unfortunately the changes seen did not improve fertility," said Haisenleder. "Infertility within this population remains an important health issue, and will require further studies to address the problem in the future."

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