If you are obese when you become pregnant you are at risk for gestational diabetes, premature delivery, high blood pressure in pregnancy as well as other complication.
Bariatric surgery has been the gold standard for reliable and sustained weight loss in some age groups, is known to help those with obesity achieve reduce chances of having obesity related diseases. In a Swedish study of over 2000 individuals the average weight loss after bariatric surgery was 23% at 2 years out. At 10 years out sustained losses of weight were 18%. It is important for those who have bariatric surgery to keep up with the recovery regimens recommended.
However, bariatric surgery chances how you absorb important micronutrients and this could put your baby at risk for poor growth. It is too soon to say how the GLP-1 medications will impact pregnancy. If you actually lost weight with the Semaglutide the FDA recommends being off for 2 months prior to pregnancy planning.
A study by Kaiser Permanente published in the March 2023 issue of Obstetrics & Gynecology looked at those who chose bariatric surgery before pregnancy as opposed to those who did not, to help answer the question of whether the surgery should help moms and babies be healthier.
Because obesity is linked with so many other conditions, one of the faults of the study is that the patients were a very mixed group.
Overall the results were conclusive that rates of preeclampsia, diabetes, and abnormally large babies were lower in moms who were pregnant after the bariatric surgery, but it was still a probably that some moms also had small for gestational age babies, which is thought to be due to the persistent problem of lacking certain nutrition after the surgery. Thus in some women medically supervised weight loss may be a better strategy prior to pregnancy. Consulting a pregnancy planning physician is important prior to conceiving.