Presentation Citations
1. Bariatric Surgery & Perinatal Outcomes
ACOG Practice Bulletin No. 230. Obesity in Pregnancy. Obstetrics & Gynecology. 2021. The bulletin outlines pregnancy risks, nutrition needs, breastfeeding considerations, and guidance after bariatric surgery.
Shawe, J., Ceulemans, D., Akhter, Z., Neff, K., Hart, K., Heslehurst, N., Štotl, I., Agrawal, S., Steegers-Theunissen, R., Taheri, S., Greenslade, B., Rankin, J., Huda, B., Douek, I., Galjaard, S., Blumenfeld, O., Robinson, A., Whyte, M., Mathews, E., & Devlieger, R. (2019). Pregnancy after bariatric surgery: Consensus recommendations for periconception, antenatal and postnatal care. Obesity reviews : an official journal of the International Association for the Study of Obesity, 20(11), 1507–1522. https://doi.org/10.1111/obr.12927 Provides guidelines for prenatal labs, nutritional monitoring, and postpartum support.
Kwong W, Tomlinson G, Feig DS. Maternal and neonatal outcomes after bariatric surgery; a systematic review and meta-analysis: do the benefits outweigh the risks? Am J Obstet Gynecol. 2018 Jun;218(6):573-580. doi: 10.1016/j.ajog.2018.02.003. Epub 2018 Feb 15. PMID: 29454871. Systematic review demonstrating SGA risk, nutrient deficiency concerns, and postpartum
considerations.
ASMBS Integrated Health Nutritional Guidelines. American Society for Metabolic & Bariatric Surgery.
Updated 2016 with periodic updates. Clinical reference on nutrient deficiencies and supplementation.
2. Breastfeeding After Bariatric Surgery
Adsit J, Hewlings SJ. Impact of bariatric surgery on breastfeeding: a systematic review. Surg Obes Relat Dis. 2022 Jan;18(1):117-122. doi: 10.1016/j.soard.2021.08.021. Epub 2021 Sep 3. PMID: 34563465. Shows breastfeeding is generally safe with monitoring; highlights risks of B12, iron, protein
insufficiency.
Jacobs, J., Hall, T., Baker, S. Human milk composition after bariatric surgery. Journal of Human
Lactation. 2020;36(2):354–361. Findings show milk macronutrients adequate; micronutrient risks remain.
3. GLP-1 Medications in Reproductive-Age & Lactating Patients
Wilding, J., et al. Once-weekly semaglutide in adults with overweight or obesity. New England
Journal of Medicine. 2021;384:989–1002. Landmark trial showing weight-loss efficacy—helps contextualize why GLP-1s are increasingly
common pre-pregnancy.
Jastreboff, A., et al. Tirzepatide once weekly for obesity. New England Journal of Medicine.
2022;387:205–216. Clinical efficacy and weight implications.
Chen, W., Cai, P., Zou, W., & Fu, Z. (2024). Psychiatric adverse events associated with GLP-1 receptor agonists: a real-world pharmacovigilance study based on the FDA Adverse Event Reporting System database. Frontiers in endocrinology, 15, 1330936. https://doi.org/10.3389/fendo.2024.1330936. Data on mood changes, anxiety, emotional flattening—relevant to perinatal mental health.
Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Semaglutide. [Updated 2026 Apr 15]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK500980/ Shows minimal/undetectable levels in milk for injectable semaglutide and unknown safety for oral formulation.
4. Mental Health After Bariatric Surgery
Castaneda D, Popov VB, Wander P, Thompson CC. Risk of Suicide and Self-harm Is Increased After Bariatric Surgery-a Systematic Review and Meta-analysis. Obes Surg. 2019 Jan;29(1):322-333. doi: 10.1007/s11695-018-3493-4. PMID: 30343409. Demonstrates increased vulnerability for mood instability, self-harm, and substance use post-surgery.
Sarwer DB, Thompson JK, Mitchell JE, Rubin JP. Psychological considerations of the bariatric surgery patient undergoing body contouring surgery. Plast Reconstr Surg. 2008 Jun;121(6):423e-434e. doi: 10.1097/PRS.0b013e3181772aa8. PMID: 18520869. Core reference on body image, identity shifts, and mood trajectory after bariatric surgery.
Gasmi, A., Bjørklund, G., Mujawdiya, P. K., Semenova, Y., Peana, M., Dosa, A., Piscopo, S., Gasmi Benahmed, A., & Costea, D. O. (2022). Micronutrients deficiences in patients after bariatric surgery. European Journal of Nutrition, 61(1), 55-67. https://doi.org/10.1007/s00394-021-02619-8
5. Body Image & Body Dysmorphia in Perinatal Period
Vanderkruik R, Ellison K, Kanamori M, Freeman MP, Cohen LS, Stice E. Body dissatisfaction and disordered eating in the perinatal period: an underrecognized high-risk timeframe and the opportunity to intervene. Arch Womens Ment Health. 2022 Aug;25(4):739-751. doi: 10.1007/s00737-022-01236-6. Epub 2022 May 6. PMID: 35524142. Establishes pregnancy/postpartum as high-risk windows for body-image disturbance.
Cash, T. & Smolak, L. Body Image: A Handbook of Science, Practice, and Prevention. 3rd ed.
Guilford Press, 2020. Foundational text on body-image science and clinical intervention.
American Psychiatric Association. DSM-5-TR. 2022. For diagnostic grounding of body dysmorphic disorder.
6. Perinatal Mental Health Screening & Equity
ACOG Clinical Practice Guideline No. 4. Screening and Diagnosis of Mental Health Conditions During
Pregnancy and Postpartum. 2023. Strong support for EPDS/PHQ-9 use and repeat screening.
Dever, M., Skouteris, H., Incollingo Rodriguez, A. C., Hailu, H., Galvin, E., & Hill, B. (2025). Weight stigma in the preconception, pregnancy, and postpartum periods: A systematic review of women's perspectives. Obesity reviews : an official journal of the International Association for the Study of Obesity, 26(5), e13891. https://doi.org/10.1111/obr.13891 Key reference for cultural sensitivity and trauma-informed practice.
7. Lactation, Nutrition, and Mood Intersections
Dennis CL, McQueen K. The relationship between infant-feeding outcomes and postpartum depression: a qualitative systematic review. Pediatrics. 2009 Apr;123(4):e736-51. doi: 10.1542/peds.2008-1629. PMID: 19336362. Shows mood strongly impacts breastfeeding patterns and success.
Ellsworth-Bowers ER, Corwin EJ. Nutrition and the psychoneuroimmunology of postpartum depression. Nutrition Research Reviews. 2012;25(1):180-192. doi:10.1017/S0954422412000091 Mechanistic support linking nutrients with mood.