A novel system dynamics model of female obesity and fertility.
OBJECTIVE
Our objective was to create a system dynamics model specific to weight gain and obesity in women of reproductive age that could inform future health policies and have the potential for use in preconception interventions targeting obese women.


METHODS
We used our system dynamics model of obesity in women to test various strategies for family building, including ovulation induction versus weight loss to improve ovulation. Outcomes included relative fecundability, postpartum body mass index, and mortality.


RESULTS
Our system dynamics model demonstrated that obese women who become pregnant exhibit increasing obesity levels over time with elevated morbidity and mortality. Alternatively, obese women who lose weight prior to pregnancy have improved reproductive outcomes but may risk an age-related decline in fertility, which can affect overall family size.


CONCLUSIONS
Our model highlights important public health issues regarding obesity in women of reproductive age. The model may be useful in preconception counseling of obese women who are attempting to balance the competing risks associated with age-related declines in fertility and clinically meaningful weight loss.
Nasim S. Sabounchi and Peter S. Hovmand are with the Social System Design Lab, George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO. Nathaniel D. Osgood is with the Department of Computer Science, University of Saskatchewan, Saskatoon. Roland F. Dyck is with the Department of Medicine, College of Medicine, University of Saskatchewan. Emily S. Jungheim is with the Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO.
Nasim S
NS
Sabounchi
Peter S
PS
Hovmand
Nathaniel D
ND
Osgood
Roland F
RF
Dyck
Emily S
ES
Jungheim
D000328:Adult; D015992:Body Mass Index; D004032:Diet; D015444:Exercise; D005260:Female; D005298:Fertility / Q000502:physiology*; D005300:Fertility Agents, Female / Q000008:administration & dosage; D006801:Humans; D008962:Models, Theoretical; D009765:Obesity / Q000503:physiopathology* / Q000523:psychology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors; D015430:Weight Gain; D015431:Weight Loss / Q000502:physiology*; D016387:Women's Health
D005300:Fertility Agents, Female