Obesity, Pregnancy, and Cardiovascular Prevention: A Lifestyle Medicine Call to Action for Preconception Health.

Obesity in women of reproductive age is a major and growing contributor to adverse pregnancy outcomes and long-term cardiovascular disease (CVD). Pregnancy is increasingly recognized as a physiological stress test that can reveal underlying cardiometabolic vulnerability. In this context, obesity amplifies risk through inflammation, endothelial dysfunction, and metabolic dysregulation. A life-course approach to prevention identifies preconception health as a critical and actionable window for intervention. Lifestyle medicine, through its core pillars of nutrition, physical activity, sleep, stress management, avoidance of harmful substances, and social connection, offers effective strategies to optimize cardiovascular health before pregnancy. Integrating structured lifestyle interventions into preconception care has the potential to improve maternal outcomes, reduce long-term cardiovascular risk, and promote intergenerational health.