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Pregnant Women Need More Help To Control Weight Gain

By Rebecca Odes |

pregnancy weight gainIt has lately been brought to our attention that pregnant women are gaining too much weight. Half of normal weight women gain more than the recommended amount. The number climbs—as the recommended weight gain drops—for overweight and obese women.

Too much weight gain is becoming an ever-greater cause for concern for both pregnant women and their babies. For women, excessive weight gain is tied to health problems during pregnancy and a greater chance of obesity afterwards. (The more weight you gain, the harder it is to lose). And since a mom’s weight gain has been linked to her baby’s weight, gaining a lot in pregnancy makes it more likely that your baby will be large, harder to deliver, and at greater risk of certain health problems. High birth weight babies are also more likely to be obese as children.

So. Doctors are highly motivated to find ways of helping pregnant women stay within the recommended weight gain guidelines. And it seems they may have found at least a clue to a way to make that happen.

A multi-location study followed 400 pregnant women in various weight ranges. The women were split into two groups. One group received standard obstetric care with minimal counseling about weight gain, diet or activity level. The other group was given specific calorie goals, ranging from 1500 to 2800 calories a day, depending on starting weight. They were urged to exercise regularly, either by walking (10,000 steps a day as measured by a pedometer) or  30 minutes of moderate physical activity of their choice most days of the week. The women in the second group were also counseled individually by a nutritionist, and received check-in calls from a healthcare provider throughout pregnancy. The frequency of the calls increased if weight gain began to exceed ideal guidelines.

The results: Many more women were able to stay within weight gain recommendations. This method was most effective for normal weight women and less so for overweight or obese women. It’s not clear why this is, but  I’m guessing the fact that it’s a whole lot easier to stay on a 2800 calorie a day diet than a 1400 calorie one might have something to do with it. And then, there’s the possibility that overweight and obese women may have a different relationship to exercise, and the complex relationships to food, and too many other factors to try to figure out.

Women who received help with diet and exercise were almost twice as likely to return to pre-pregnancy weight within six months after birth. This increase was seen in the full range of women: normal, overweight and obese.

I’d be interested in knowing how the women in this study felt throughout the program.  Were the check ins invasive, or helpful? Did they feel supported, or micromanaged? I’m wary of things that make women feel like they’re under a microscope. But if weight gain is such an important issue, then pregnant women are absolutely going to need tools and support to stay within the boundaries. Managing weight is not easy for most women at any time, and arguably much harder while pregnant.  Just giving the women the numbers and sending them on their way is a setup for failure…and guilt. I’m not sure if the care the women received in this study is realistic for pregnancies across the board (health care being what it is) but what if it were? Would you be into it?

photo: [ecoECO]/flickr

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About Rebecca Odes

rebecca-odes

Rebecca Odes

Rebecca Odes is a writer, artist and mother. She was inspired to write her blog, From The Hips, during her first pregnancy when she discovered every pregnancy book she came across made her feel anxious or irritated. She lives in New York City with her husband and two children.

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0 thoughts on “Pregnant Women Need More Help To Control Weight Gain

  1. mom of 2 says:

    I think pregnancy weight gain is another one of those one size does not fit all issues. For women who have pre-pregnancy weight issues and need diet and exersise counseling, these are probably useful during pregnancy as well. For women who do not, I think all this is just invasive and unnecessary. I had a prepregnancy weight of 133 lbs before each of my kids and gained 47 and 50 pounds with them, respectively. This is considered (uh, way) too much but now, again, I weight 133 pounds. (Yes, it’s weird. This is my body’s weight, apparently.) Yes, it took more than a year for me to lose the excess pregnancy weight. (I don’t drop weight while breastfeeding), but it wasn’t overly difficult either. The weight came off in it’s own time as my metabolism and appetite returned to normal. So for me, the weight conversation seems a little silly, and I think a lot of women have bodies like mine. However, a lot of women have different kinds of bodies. Weight, calorie and exercise guidelines may be very helpful for those women. I just don’t see the need to make everyone conform to some arbitrary guideline.

  2. Jessi says:

    It sounds good in theory, but highly invasive in actual application. With my second pregnancy, I had a doctor who discussed my weight at every visit and if what I had gained was appropriate. Toward the end of the pregnancy, in a visits 2 weeks apart, I had gained over 5 pounds. My doctor seemed extremely concerned, made sure it wasn’t health related, and then quizzed me on why I had gained so much. The truth was that I had eaten out more than I generally do and I was pretty constipated. But, I felt like I was getting the third degree. It did make me watch my weight more, but it also made me dread my doctor visits. How can that be a positive thing?

    With this pregnancy, my third, my new doctor hardly brings up my weight. I have gained a little more than last time, but I was starting at a slightly higher weight. I’ve still tried to keep it manageable and will probably end up gaining around 35-40lbs overall. The experience with this doctor has been MUCH more pleasant and I never dread a visit.

    There’s something to be said for not making pregnant women feel terrible about themselves. Many of us feel unattractive and miserable enough already.

  3. Rebecca says:

    I totally agree. Weight gain is really individual. One person can gain 75 pounds and easily work it off (well, not necessarily easily, but do-ably) and another can find 20 lbs intractable. I do worry about how applying a system across the board would reflect on the individual. But one thing I liked about the program in this study was that there was at least some personalized attention, so people were able to communicate about their metabolisms, weight histories, exercise habits and other factors that would play into recommendations. The problem is when a system is applied to everyone without room for adjustment. I worry that in the interest of cost-cutting, the results of this study could be translated into just that, and we’ll end up losing the part that’s likely the most helpful: the individual attention and support.

  4. Michelle says:

    I am currently 13 weeks into my 4th pregnancy. My First 3 pregnancies I gained exactly 25 pounds each time and what I did during each pregnancy didnt seem to change the weight gain since they were all the same amount in the end. This pregnancy I am right on the border between overweight and obese (the last 2 I was overweight still but about 20 pounds lighter). My Doctor (which is a new one for me this time) was obviously concerned about my weight in my first appointment but kinda asked all kinds of questions about my weight and health and then told me not to gain any wieght until I was 20 weeks. And that was that. No advice about how to accomplish this and no discussion of what the weight issue could mean for me and my baby. I would very much have appreciated some kind of guidance and help, Id even like some checking up on if it was done in a positive way where we could discuss how I could adjust things if I was gaining too much, instead of just being told I need to not gain more. I would like to go through with this pregnancy as healthily and with as little complication as I canIm just not really sure how to do that.

  5. Audrey says:

    Long ago, before the days of ultrasound, I was told that I was going to have a 7 pound baby. She ended up 9 lbs. 5 oz. I had three other nine plus pound girls who all were 20 pounds at a year. I gained 40 pounds for each pregnancy, lost it within a year and guess what? All FOUR of my adults daughters are at a VERY normal weight! I encouraged my four girls to eat a healthy and balanced diet during their pregnancies. They too gained about 40 pounds for each of their babies. My girls lost their weight and their kids are all normal weights! Do you think there is a heredity factor involved here?

  6. chloe Lee says:

    Nice..This kind of bodybuilding promotes a healthy lifestyle and discourages gaining to build muscle at the cost of damage to the body. Bodybuilders make use of some fundamental strategies to build their muscle mass. Many teens nowadays want to have healthier, more beautiful bodies. To achieve this, they stick to a regular regimen of bodybuilding exercises.

  7. Z says:

    I think for some women personalized support and guidance could be a huge help.. IF it’s done in a supportive manner. If you’re made to feel guilty over it you’re just going to be miserably pregnant and possibly not get all the nutrients you need. Too many women out there are already willing to starve themselves because of what the scale says. Pregnancy would be the worst possible time to do that.

    I think education is really the key to gaining a healthy amount of weight (for each individual). Knowing how to eat healthy is going to do you far more good than just being told ‘gain X amount of pounds’. I also think the whole ‘eating for two’ thing needs to be put to rest. You are NOT eating for a second person. The amount of extra calories needed are really not all that much. Far too many women use pregnancy as a validation to splurge on everything and anything they want even when they might otherwise pass on that second piece of cake or have a piece of fruit or some carrot sticks instead of it. It’s supposed to be a happy time of our lives but that doesn’t mean we should throw everything we know about nutrition out the window just because we’re craving pancakes for the third time in one afternoon.

  8. Yesenia says:

    I am an ovverweight female and I am 34 weeks pregnant. So far I have gained only 8lbs the enitire 34 weeks. My doc use to worry about my wieght gain at first (she thought I was starving myself) but the funny thing is I ate as much as I usually do but I have kept myself more active. I hope to lose More then what i have gained agfter the baby is born. But we shall see.

  9. Shanna says:

    Weight in any context is always a touchy issue. But I think that when it comes to the health of their baby, most women would probably prefer to have some candid help from their doctors regarding weight gain. I know SO many women who were never talked to once about nutrition during their pregnancy. My midwife discusses it with me at every single visit, and has provided me with guidelines all throughout my pregnancy. And it’s not just about calories and what you shouldn’t be eating, but it’s much more about the nutrition that your baby needs during certain developmental periods of your pregnancy. Being overweight is an indication that you are not eating healthy food, and if you aren’t eating nutrients your baby needs, that’s harmful to your child. So to me that’s where the concern about overweight women comes from, is that it’s indicative of an overall nutritional deficiency. My midwife always tells me that if I’m honestly eating majority healthy food-fruits, veggies, whole grains, etc. and I’m still gaining a lot of weight she doesn’t have a problem with it. It’s WHAT you eat much more than it is how much.

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