Obesity And Pregnancy: Don’t Obsess
Thornton’s study was “very interesting and timely work … an admirable research effort,” Bill Barth Jr., MD, tells WebMD. Barth is an associate professor at Harvard Medical School and chief of the division of maternal-fetal medicine at Massachusetts General Hospital.
“The study, if it’s confirmed by larger studies, suggests that women who have a body mass index over 30 may not need to gain weight at all if in a supervised program,” Barth says. “Ideally, this would be covered by a clinical nutritionist or a nurse or a physician with special training and experience in dietary counseling.”
Michelle Owens, MD, assistant professor of maternal-fetal medicine at the University of Mississippi Medical Center in Jackson, Miss., has had many obese patients who’ve gotten pregnant.
Praising Thornton’s study, Owens says people tend to “obsess” about how much weight they should gain during pregnancy.
“But in actuality, those numbers are firmly rooted in basic behavioral and nutritional habits,” Owens says. “I think that that needs to be cornerstone, rather than obsessing over the number, because you can still make a significant impact without necessarily meeting a numeric goal.”
Pregnancy can be an ideal time to move toward healthier eating, Owens notes.
Diet And Exercise During Pregnancy
A balanced, nutritious diet becomes more important during pregnancy. And a program of physical activity is helpful as well. Your healthcare team can provide you with the best personalized advice. But there are also some general diet and exercise tips you can use to start a conversation with your doctor.
Starting With Weight Gain
Pregnancy has probably got you thinking more about the effects of being overweight. Do you actually know how overweight you are? Facing the reality can help you make realistic choices. Its not just the number on the scale. You should also know your Body Mass Index . BMI takes into account your height and weight, and is an estimate of body fat. If your BMI is between 25 and 29.9, you are overweight. If it is 30 or more, you are obese. If you dont know, here is a BMI calculator. Strive to limit your weight gain during pregnancy.
BMI 25 to 29.9: 15 to 25 pounds
BMI 30 or higher: 11 to 20 pounds
You may lose some weight naturally. The first trimester, women can lose weight as a result of morning sickness. Your baby will still get necessary nutrients because overweight women have a reserve of calories in stored fat. So losing a little weight naturally will not hurt your baby. Also, your body uses more calories during pregnancy, so if you dont increase your consumption, youll probably lose some weight. Your bodys priority is to provide your baby nutrition. As the calories you consume go toward babys growth, your body may resort to using fat stores to keep you going leading to weight loss.
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Cut Back On Your Calorie Intake
If youre already at an unhealthy weight and have been advised to lose some of it, you will have to start keeping track of your calorie intake. Cutting back on calories when not pregnant is different from cutting back calories when pregnant. You wouldnt want to end up depriving your baby of the nutrients he/she needs by slashing way too many calories from your daily diet.
You may need to consult your doctor or a dietitian to find out how many calories per day you should consume. The easiest way to keep track of your calorie intake is to make a weekly meal plan. This way, you wont have to count your calories during every meal. Check nutritional labels when doing your groceries, or find recipes online that already specify how many calories are present.
Generally, a pregnant woman should not eat fewer than 1,700 calories a day. This is the minimum needed to support both your energy and nutrient needs and those of your babys.
Here are simple ways to reduce your calorie intake:
- Eat smaller portions.
- Use plant-based oils, such as olive oil, and skip unhealthy fats, such as butter.
- Eat more fresh fruits and vegetables and less of traditional carbs.
- Keep junk foods and sweet desserts to a minimum.
- Drink water instead of soda and other sweetened beverages.
Frequently Asked Questionsexpand All
- What is obesity?
Being overweight is defined as having a body mass index of 25 to 29.9. Obesity is defined as having a BMI of 30 or greater. Within the general category of obesity, there are three levels that reflect the increasing health risks that go along with increasing BMI:
Obesity category IBMI of 30 to 34.9
Obesity category IIBMI of 35 to 39.9
Obesity category IIIBMI of 40 or greater
You can find out your BMI by using an online BMI calculator.
Obesity during pregnancy puts you at risk of several serious health problems:
PreeclampsiaPreeclampsia is a serious form of gestational hypertension that usually happens in the second half of pregnancy or soon after childbirth. This condition can cause the woman’s kidneys and liver to fail. In rare cases, seizures, heart attack, and stroke can happen. Other risks include problems with the placenta and growth problems for the fetus.
Gestational diabetesHigh levels of glucose during pregnancy increase the risk of having a very large baby. This also increases the chance of cesarean birth. Women who have had gestational diabetes have a higher risk of diabetes mellitus in the future. So do their children.
StillbirthThe higher the womans BMI, the greater the risk of stillbirth.
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Why Should I Exercise During Pregnancy
Staying active during pregnancy will help you to slow weight gain and have a healthier pregnancy and delivery. Exercise is safe for most pregnant women. Talk to your health care provider to find out what type of physical activity is safe for you.
- Benefits of exercise during pregnancy
- Slows weight gain
Did You Know? Women who exercise during pregnancy may have shorter labors and easier deliveries.
Exercise For Weight Loss During Pregnancy
Some women stop working out when they get pregnant. They fear that it might be dangerous to their unborn child. Well, that is not totally true. Lots of them dont know how to lose weight while pregnant with some exercises.
However, you should consult your doctor before you begin any exercise regimen. You need to find out the kind of exercises that can help you lose weight and keep your body healthy for birth. Some of the safe exercises for women during pregnancy include:
- Bleeding or any gush of fluid secretion from your vagina
- Painful contractions in your uterus
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How Much Weight Should I Gain
You should gain weight gradually during your pregnancy, with more of the weight gained in the last 3 months. Many health care providers suggest women gain weight at the following rate:
- 1 to 4 pounds total during the first 3 months
- 2 to 4 pounds per month during the 4th to 9th months
The total amount of weight to gain during pregnancy depends on how much you weighed when you became pregnant. Talk with your health care provider and WIC nutritionist to find out what amount is right for you.
What Can I Do To Slow Weight Gain
If youre gaining more weight than recommended, talk to your health care provider or WIC nutritionist. You should never try to lose weight during pregnancy. But slowing weight gain can help you have a healthier pregnancy and delivery, and an easier time getting back to your pre-pregnancy weight.
To slow weight gain
- Enjoy your food, but eat less
- Avoid oversized portions
- Make half your plate fruits and vegetables
- Switch to fat-free or low-fat milk. Calcium- fortified soy milk is a good choice for those that choose not to drink milk.
- Make at least half your grains whole grains
- Drink water instead of sugary drinks
- Find your balance between food and physical activity
Did You Know? Pregnancy only requires around 300 extra calories a day.
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What’s Causing The Weight Gain
Much of the weight that you gain during pregnancy is not fat, but is related to the baby. Here is a breakdown of how 35 pounds adds up:
- Baby: 8 pounds
- Placenta: 2 to 3 pounds
- Amniotic fluid: 2 to 3 pounds
- Breast tissue: 2 to 3 pounds
- Blood supply: 4 pounds
- Fat stores: 5 to 9 pounds
- Uterus growth: 2 to 5 pounds
Weight Loss During Pregnancy Second And Third Trimester
Pregnant women can naturally lose weight by involving in lifestylechanges, but shouldnt be made with the goalto lose weight forcefully.
However, one may consider losing weight when pregnant if your body mass index is too high, as it may lead to some complications during child birth. Weight loss during pregnancy should be handled with utmost care.
Pregnant women are encouraged to reach a healthyweight before they become pregnant, says the American College of Obstetrics and Gynecology. But the challenge is what if the woman gets pregnant unexpectedly while being over-weight? How can she safelylose weight to avoid complications.
A reproductive endocrinologist and infertility specialist, Dr Julie Rhee says pregnant women who are obese should continue having a healthydiet and exercise program. A healthy diettogether with exercises and portion control and properly balanced mealare encouraged, but with a few caution. Practicing portion control is healthyduring pregnancy.
Anyone who is using medications or supplements for weight loss should consult medical personnel to ascertain their safety while pregnant. Moreover, bear in mind that dietswhich restrict you from eating a several food groups altogether should be avoided.
During pregnancy, women are advised to take part in exercises, but such exercisesshould not be strenuous ones. You shouldnt engage in physical activities that are not comfortable for you or that requires you to push very hard.
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Do Light Exercise In Pregnancy:
Exercise not only reduces weight, but exercise done during pregnancy is essential for healthy weight gain. Pregnant women should do a total of two and a half hours of aerobic activity a week.
Exercise provides relief from pain in pregnancy, and it leads to good sleep and mental health. Regular exercise should be done to reduce the complex problems of pregnancy. This helps in weight loss after pregnancy.
Talk to your doctor and consult before starting any exercise. If you have bleeding or any other problems during the exercise, stop it and contact your doctor immediately.
Walking, swimming, dancing, cycling, etc. are some excellent types of exercise that you can choose from:
Activities such as kick-boxing, basketball, which are prone to stomach injuries, and horse riding, which are likely to fall, be abandoned entirely in pregnancy.
Also, avoid scuba-diving as there is a possibility of gas bubbles forming in your childs blood.
Know When Weight Loss May Occur:
Weight loss during pregnancy is not recommended, but for many women, weight gain during the first trimester is healthy.
Many women experience challenging symptoms of nausea and vomiting. The symptoms of such nausea in the first trimester are quite intense. In this state, it becomes difficult to eat normally.
Losing weight is not a matter of concern, especially if you are already a little bit fat, because your baby can pull extra calories from your body meat.
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Address Weight Issues Early
Pregnancy weight gain could come naturally during pregnancy, most of the weight gain occurs in the second and third month. Your baby also develops and grows quickly during the last two trimesters of pregnancy. You cannot manage your babys weight gain and supporting elements such as the placenta, so its always best to address all weight situations earlier in pregnancy.
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Getting Ready For Pregnancy
If you are planning to get pregnant, starting a healthy eating and exercise plan now improves your chances of getting pregnant and having a healthy baby. By making healthy changes to your diet and increasing your daily physical activity, youll be taking steps toward reaching a more healthy weight. This is also important when using IVF and other assisted reproductive technologies .
Studies have found that obesity reduces the rate of pregnancy and live births in women using ART, and increases the rate of miscarriage. But weight loss through diet, lifestyle and other changes significantly improves these outcomes.
What Are The Risks Of Being Overweight And Pregnant Or Obese And Pregnant
If you have a high BMI before pregnancy or in early pregnancy, this can affect your health and how your baby develops. The higher your BMI the higher the risk.
These risks include:
- baby having a high birth weight
- obesity and diabetes in their later life.
This can be difficult to read but try not to worry. You will have extra care throughout your pregnancy and there are lots of things you can do to minimise the risks and have a healthier pregnancy.
You can sometimes be made to feel like the worst mum in the world because you are overweight. But all that any woman wants is a healthy pregnancy and baby. So try not take it to heart or feel targeted when healthcare professionals talk about obesity, because they are just following what the guidelines say. Remember that managing your weight and making healthier food choices is useful advice for everyone in pregnancy, regardless of their size. You are making informed choices that are the best for you and your baby, just like everyone else.
Tammy, mother of six
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Find Out How Much Weight You Need To Gain
Even if you are overweight, you will gain some kilos during pregnancy for the well-being of your child. Measure your current weight, and with the help of a pregnancy chart, calculate how much weight you need to gain. Aim to stay within that limit. Be sure to weigh yourself at the same time each day and on the same scale. Limit your weight watching to once a week as fluctuations are normal and weighing yourself daily will only lead to unwanted stress and anxiety.
Bonus: Do Bodyweight Exercises
Bodyweight exercises are ideal for pregnant women because they have a very low injury risk.
However, stay away from exercises that involve a lot of jumping like burpees. Instead, do low impact exercises like squats.
If youre in your first trimester, add these 28 fat-burning workouts to your routine.
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Know Your Weight Needs
The amount of weight that you should gain during pregnancy depends on your pre-pregnancy BMI . Before you decide to lose weight during pregnancy, it is good to know your threshold for pregnancy weight gain. The below chart helps you know how much weight you can gain :
|Pregnancy weight category
: Institute of Medicine/ ACOG
According to ACOG, women who are overweight or obese can gain lesser weight than that recommended as long as the baby is growing fine.
What Happens At Your First Appointment When Pregnant
Wondering when to make your first doctors appointment? Its a good idea to schedule it as soon as your pregnancy test comes back positive. The earlier you can get your first ultrasound, the better. This will help date your pregnancy and give you a sense of when your baby will be due.
Bear in mind that if youre overweight, it may be tougher to date your pregnancy accurately for two reasons. First, ovulation is often more irregular in obese women. And second, it may be harder to measure your baby using an ultrasound, which is the traditional way practitioners estimate gestational age.
Your doctor may also test you for gestational diabetes early on because being overweight increases your risk. If you test positive, youll need to monitor your blood sugar at home. If not, your doctor will check your blood pressure and look for protein in your urine at every checkup and youll likely receive a second test later in pregnancy.
At this point, its also smart to consider the relationship you have with your practitioner and his or her willingness to help you with your healthy living goals. If you think youre experiencing weight bias, make a change. You deserve the best possible care so get recommendations and note that if you switch OB/GYNs, do so in the first trimester if possible, since some doctors may not accept patients later on.
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When Youre Told Youre Too Fat To Get Pregnant
Does it make sense, medically or ethically, when fertility clinics refuse to treat prospective mothers they consider too large?
Gina Balzano and her son in Waltham, Mass.Credit…Elinor Carucci for The New York Times
The first time a doctor told Gina Balzano that she was too fat to have a baby was in 2013. She was 32, weighed 317 pounds and had been trying to get pregnant since soon after she and her husband, Nick, married in 2010. Balzano whom I have known since high school lives in Waltham, Mass., and works in special education. Shes the kind of person whom others often go to with their problems, but her own predicament, after three years of negative pregnancy tests, had left her feeling overwhelmed. Ive always had horrible, heavy, painful periods, so I thought something was wrong, she says. But I didnt know enough to know what to worry about. She told herself it was time to find out.
During their first appointment at a large Boston fertility clinic, Balzano says, the reproductive endocrinologist was cold and unsmiling as she reviewed the couples medical history. Her first question was whether Balzano was ovulating. Irregular ovulation when a womans ovaries fail to release eggs during the appropriate phase of the menstrual cycle is one of the most common causes of infertility. Balzano wasnt sure it was difficult to track her erratic cycles at home. The specialist asked no follow-up questions. Its your weight, she said.