Obesity is known to contribute to anovulation, menstrual irregularities and sub-fertility. Furthermore, obese women who do become pregnant are at increased risk of miscarriage and obstetric complications including pregnancy-induced hypertension, preeclampsia, gestational diabetes, fetal macrosomia, and neonatal and maternal mortality. Outcomes for those undergoing IVF treatment are consistently poorer for obese individuals, and the offspring of obese women are at higher risk of becoming obese themselves and of developing heart disease, diabetes and other metabolic conditions later in life. The complex deregulatory effects of excess weight upon hormone production are thought to play a part in many of these issues.

It is clear that whilst most women are aware of the recommendations regarding pregnancy and contraception following bariatric surgery, many do not heed them. Various forms of contraception are available after weight loss surgery, and choice of method should take into account a range of personal factors including long and ​short term requirements, future plans for pregnancy, sexual health risks, age, overall health, use of other medications, efficacy and convenience.