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Obesity Management During Reproductive Years
Clinical Queries: Expert Insights to Improve Obesity Management During Reproductive Years 

Released: January 20, 2026

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Leah (30 years of age, G1P1) delivered her first child 6 months ago and just recently stopped breastfeeding. She was diagnosed with polycystic ovary syndrome (PCOS) when she was 22 years of age, and she had difficulty conceiving. To improve her chances of conceiving, she lost 8% of her body weight (~15 lb [7 kg]) with lifestyle management over 3-4 years. At conception, her weight was 180 lb (82 kg), and her BMI was 31.9 kg/m2. During pregnancy, she gained 35 lb (16 kg), which was more than the recommended weight gain of 11-20 lb (5-9 kg). She would like to get pregnant again in 1-2 years, but she is concerned because, even with breastfeeding for 6 months, her weight is still approximately 25 lb (11 kg) higher than it was before she got pregnant, and she now has more weight-related health issues (eg, borderline hypertension, prediabetes, obstructive sleep apnea [OSA]). She wants to know what she can do to lose more weight more quickly than she did before, so she can get back to her prepregnancy weight before she tries to conceive again.

Examination:

  • Height: 63 in (160 cm)
  • Weight: 206 lb (93 kg)
  • BMI: 36.5 kg/m2
  • Waist circumference: 52 in (132 cm)
  • Blood pressure: 134/82 mm Hg

Laboratory results:

  • A1C: 6.3%
  • Total cholesterol: 237 mg/dL
  • Low-density lipoprotein cholesterol: 153 mg/dL
  • High-density lipoprotein cholesterol: 47 mg/dL
  • Triglycerides: 184 mg/dL

Medications:

  • Prenatal vitamins

Which of the following would you recommend to Leah as the best option based on her weight loss, health, and family planning goals?