Obesity is a real risk factor for birth, it has a negative impact on the reproductive system. Therefore, having a good body weight, an adequate lifestyle and a healthy diet favor fertilization, also through medically assisted procreation (PMA) techniques, considering that embryos are more commonly implanted in subjects with normal weight. Therefore, the new law recognizing obesity as a disease is a fundamental step for the Italian health service, as it opens up new perspectives for intervention and also provides significant results for reproductive health. Our country was one of the first countries in the world to adopt special legislation for the prevention and treatment of this chronic and relapsing pathology.
When we talk about overweight and, in general, obesity, we must remember that adipose tissue is a true endocrine organ, which processes hormones and negatively impacts the hypothalamic-pituitary axis that regulates the function of the gonads. As a result, there is a decrease in the quantity and quality of oocytes, namely female germ cells, as well as the quantity and quality of spermatozoa. This significantly reduces a couple’s chances of getting pregnant. In fact, obesity has an important impact on fertility, both in men and women: in women, obesity inhibits ovulation, hormonal regulation and affects the quality of the endometrium, while in men, obesity is known to be associated with reduced sperm quality.
Thanks to this new law, the first decisive steps have been taken towards a systemic and 360° approach to this pathology, which must be able to involve more specialists, institutions and local communities, to implement coordinated preventive and training measures, especially to protect the new generation. It is important to remember that the text, which is a parliamentary initiative, also provides for training plans for doctors and pediatricians and the creation of an Observatory in the Ministry of Health to study obesity, an important tool that, it is hoped, can communicate concretely with assisted procreation centers, knowing that this pathology is, in any case, a real clinical risk factor for infertility. As the Minister of Health, Orazio Schillaci, also observed, ‘with this law the commitment to combating obesity is strengthened by a firm focus on prevention as well as specific training for health workers’.
In addition, it should not be forgotten that there is a genetic predisposition to obesity, which is caused by the activity of many genes that can be modified with the right lifestyle. This is not just a monogenic fact, namely determined by the transmission of one gene from parent to child, but a polygenic transmission, namely determined by different genes that can interfere, for example, with the control of satiety and appetite. However, these genes can be activated or suppressed depending on the type of nutrition we follow. Basically, there is a so-called epigenetic influence on the expression of these genes. This is why nutrition is important: there are certain foods that are rich in certain substances called methyl groups, which affect DNA and are able to activate or deactivate it.
Lifestyle, nutritional education, professional training for health professionals are important aspects to combat obesity, with the realization that it is necessary to take action in various fields from childhood. In this process, schools must also play a major role in full coordination with families.
