Obesity Management: Implications for Contraceptive Counseling and Reproductive Health

Abstract Purpose of Review Recommendations for contraceptive use and pregnancy timing in bariatric surgery patients are established, but there is limited information regarding the reproductive health implications of anti-obesity medications. This review aims to explore the current knowledge on how both anti-obesity surgery and medications impact reproductive health while highlighting gaps that warrant further investigation. Recent Findings It is generally recommended that pregnancy is avoided for 12–18 months after bariatric surgery. Malabsorptive procedures reduce the effectiveness of oral contraceptives. There are limited studies on the safety of anti-obesity medications in pregnancy. In addition, anti-obesity medications may interact with contraceptives, requiring nuanced contraceptive counseling. Summary Obesity treatments have the potential to improve ovulatory function and pregnancy outcomes in women of reproductive age. Current guidelines recommend delaying pregnancy immediately after bariatric surgery. In addition, after malabsorptive surgeries, oral contraceptives may be less effective and so an alternative form of contraception is recommended. Current guidelines also recommend avoiding pregnancy while on anti-obesity medications. However, there are limited data regarding specific effects of anti-obesity medication on pregnancy or potential drug-drug interactions with oral contraceptives.