Understand why weight loss medications require extra care during pregnancy and breastfeeding, according to gynecologist Dr. Mariana Amora Cocuzza
So-called weight loss pens, which include drugs from the GLP-1 analogue class and related molecules, represent an important advance in metabolic medicine. They help control type 2 diabetes, insulin resistance and the treatment of obesity, with cardiovascular benefits in selected patients.
Pregnancy is not a phase for weight loss medications
However, pregnancy is not the time for weight loss interventions. During pregnancy, the focus should be on the baby’s proper development and the mother’s safety. And, in this context, these medications are contraindicated.
GLP-1 analogues work by reducing appetite and delaying gastric emptying. Although these mechanisms are useful in metabolic treatment, they were not developed for use during pregnancy.
Studies in animal models have demonstrated possible risks to fetal development, including changes in growth. In humans, data is still limited, but the lack of robust safety evidence is enough to contraindicate its use.
Furthermore, intentional weight loss during pregnancy is not recommended, except in very specific situations and always under strict medical guidance. Adequate gestational weight gain is part of the physiological process of pregnancy.
Reproductive planning requires anticipation
Women of childbearing age who use these medications need to discuss reproductive planning with their doctor. Guidance must be individualized. Getting pregnant while taking medication requires immediate medical evaluation to determine the best course of action.
This care is particularly important because many pregnancies are unplanned. The conversation about contraception and reproductive intention should be part of the monitoring of women who use these drugs.
Postpartum and breastfeeding: extra caution
In the postpartum period, especially during breastfeeding, the priority remains the baby’s safety. There is insufficient evidence that these medications are safe during lactation and, as a precaution, their use is not recommended during this period.
Furthermore, the postpartum phase involves intense hormonal changes, sleep deprivation and significant emotional demands. Weight control should be approached gradually, with a focus on a balanced diet, guided physical activity and multi-professional support.
Only after the end of breastfeeding and with adequate clinical evaluation can the resumption of drug treatment be discussed, if indicated.
Weight loss pens are valuable tools when used correctly. But pregnancy and lactation represent unique phases, in which prudence must prevail. Individualized care, planning and medical monitoring are essential to protect two lives at the same time.
Dr. Mariana Amora Cocuzza – CRM 100.748
Gynecology and obstetrics
Undergraduate and postgraduate studies at the USP Faculty of Medicine
