Why is it bad to lose weight while pregnant?
August 17, 2020 5:10 AM Subscribe
I'm curious to know what is inherently so bad about losing a bit of weight if you are pregnant. I got pregnant unexpectedly while overweight and immediately made a lot of healthy lifestyle changes that could result in gradual weight loss. The internet is telling me this is terrible and I MUST gain weight, even though I am already overweight. I am wondering why that is?
This was me. It all worked out well, I told my husband and while he was shocked and not exactly thrilled, he took it very well and has since made a serious effort to "be on board", as he says. So, huge relief!
But: I got pregnant unexpectedly and at a time when I am somewhat overweight. I gained a lot of weight during my first pregancy (like 50 lbs) and never got all of it off. I do NOT want to repeat that experience, so I have made an appointment with a dietitian and plan to ask my obstetrician for advice on how to control my weight as well.
I have already begun to eat very healthy and exercise more. And so this got me thinking. I am now eating 2000 kcals a day and being very active (biking 30 mins to work and back, walking during my lunch break, doing prenatal bodyweight exercises a few times a week). I'm pretty sure I was eating more kcals before, because I ate a lot of garbage, and I was certainly more sedentary. So I should, by adopting this much more healthy lifestyle, lose a bit of fat. Perhaps even a little more than I would gain in the baby and additional blood/tissue etc. So, if I were to keep this lifestyle up, this might theoretically/hypothetically/possibly result in a minor but net weight loss over the course of my pregnancy.
I've tried googling to find sources on whether or not this is okay and it seems that every pregancy-related medical source is adament that I should still gain weight, although less than if I were a healthy weight. I've found very very limited information suggesting that not gaining weight or even losing a bit might be okay in women suffering from morbid obesity, but I am only a few lbs overweight. So apparently I have to gain weight, at least 15 lbs. My question is, why? Why would it be so terrible if I stayed the same-ish weight, maybe even lost a little bit over the course of 9 months, exchanging a portion of my body fat for a baby and getting healthier in the process?
I am eating plenty of calories, getting in all of the necessary nutrients. I would lose weight at a very reasonable rate, not by dieting but by living a healthier life. I would still have plenty of body fat left to support the baby's growth. So what is it about losing weight or not gaining enough that is inherently so dangerous for baby?
Obviously: You are not my doctor/dietitian/obstetrician. I have appointments planned with each of them and will adhere to their advice. I will also ask them this question. But in the mean time, I'm curious: why is it that every pregnancy-related source I find is telling women they Must! Not! Lose! Weight! ? Do you know of credible sources that explain exactly why this is bad even when the weight is lost slowly, responsibly, and results in a healthier body fat percentage for the mother?
This was me. It all worked out well, I told my husband and while he was shocked and not exactly thrilled, he took it very well and has since made a serious effort to "be on board", as he says. So, huge relief!
But: I got pregnant unexpectedly and at a time when I am somewhat overweight. I gained a lot of weight during my first pregancy (like 50 lbs) and never got all of it off. I do NOT want to repeat that experience, so I have made an appointment with a dietitian and plan to ask my obstetrician for advice on how to control my weight as well.
I have already begun to eat very healthy and exercise more. And so this got me thinking. I am now eating 2000 kcals a day and being very active (biking 30 mins to work and back, walking during my lunch break, doing prenatal bodyweight exercises a few times a week). I'm pretty sure I was eating more kcals before, because I ate a lot of garbage, and I was certainly more sedentary. So I should, by adopting this much more healthy lifestyle, lose a bit of fat. Perhaps even a little more than I would gain in the baby and additional blood/tissue etc. So, if I were to keep this lifestyle up, this might theoretically/hypothetically/possibly result in a minor but net weight loss over the course of my pregnancy.
I've tried googling to find sources on whether or not this is okay and it seems that every pregancy-related medical source is adament that I should still gain weight, although less than if I were a healthy weight. I've found very very limited information suggesting that not gaining weight or even losing a bit might be okay in women suffering from morbid obesity, but I am only a few lbs overweight. So apparently I have to gain weight, at least 15 lbs. My question is, why? Why would it be so terrible if I stayed the same-ish weight, maybe even lost a little bit over the course of 9 months, exchanging a portion of my body fat for a baby and getting healthier in the process?
I am eating plenty of calories, getting in all of the necessary nutrients. I would lose weight at a very reasonable rate, not by dieting but by living a healthier life. I would still have plenty of body fat left to support the baby's growth. So what is it about losing weight or not gaining enough that is inherently so dangerous for baby?
Obviously: You are not my doctor/dietitian/obstetrician. I have appointments planned with each of them and will adhere to their advice. I will also ask them this question. But in the mean time, I'm curious: why is it that every pregnancy-related source I find is telling women they Must! Not! Lose! Weight! ? Do you know of credible sources that explain exactly why this is bad even when the weight is lost slowly, responsibly, and results in a healthier body fat percentage for the mother?
As I understood it, pregnancy should not be the time for you to follow a diet in order to lose weight.
If you eat healthily (what that means is best discussed with your dietician), excercise, and it turns out you lose a little weight that way, that is not in itself a problem.
However. The other thing is that you should not immediately deny yourself what your body asks for in terms of food. Like, if you suddenly want nothing but potatoes and olives, possibly your body might be needing potatoes and olives right now. On the other hand, your body probably will never need 10 bags of poato crisps. Also, no body and no pregnancy is the same and you may e.g. be not hungry at all at first and super hungry in the later months. So that "listen to your appetite" means that following a strict nutritional plan may be difficult and you might wind up depriving your body of something it needs in the name of health.
The other answer to your "why" is that everyone and their dog feels qualified to tell a pregnant woman what not to do with her body. And also, the assumption is that pregnant women will hate getting fatter so much, they will do stupid things like trying to starve themselves thin. So We Must Tell Them Not To Be Stupid. That was my impression.
posted by Omnomnom at 5:30 AM on August 17, 2020 [21 favorites]
If you eat healthily (what that means is best discussed with your dietician), excercise, and it turns out you lose a little weight that way, that is not in itself a problem.
However. The other thing is that you should not immediately deny yourself what your body asks for in terms of food. Like, if you suddenly want nothing but potatoes and olives, possibly your body might be needing potatoes and olives right now. On the other hand, your body probably will never need 10 bags of poato crisps. Also, no body and no pregnancy is the same and you may e.g. be not hungry at all at first and super hungry in the later months. So that "listen to your appetite" means that following a strict nutritional plan may be difficult and you might wind up depriving your body of something it needs in the name of health.
The other answer to your "why" is that everyone and their dog feels qualified to tell a pregnant woman what not to do with her body. And also, the assumption is that pregnant women will hate getting fatter so much, they will do stupid things like trying to starve themselves thin. So We Must Tell Them Not To Be Stupid. That was my impression.
posted by Omnomnom at 5:30 AM on August 17, 2020 [21 favorites]
It might also be helpful to note that NICE don't recommend frequent routine weighing while pregnant. They do recommend pregnant people are encouraged to eat a healthy diet and continue with exercise. Their recommendations are aimed at medical professionals rather than normal people.
posted by plonkee at 5:36 AM on August 17, 2020 [1 favorite]
posted by plonkee at 5:36 AM on August 17, 2020 [1 favorite]
I am really glad you’ll consult specifically with your own medical team on this.
I can just share some anecdotal experience - my first child died a few days after birth and I got pregnant about 9 months later; I was still carrying about 15 extra lbs and my BMI (I know, I know) had me just into the overweight category. I did try to gain weight and for some reason (nothing came up with thyroid results etc.) I could not gain any. My obstetrical team didn’t really believe that I was eating and I had to keep a food diary. For a while I was eating 4500 calories which was gross.
Anyways, the point is they really monitored fetal growth via ultrasound and my son did have growth issues, measuring quite small and eventually weighing in at 5lbs6oz at delivery. He actually did fine overall although he lost some weight initially and it was worrisome.
For me though, bearing in mind that I was also in a strange emotional space with grief, I was *really* sick for 2 years. I had mastitis twice, I caught every cold, I came down with pertussis when my vaccine failed, and I had shingles. I have a family history of osteoporosis so I was being pretty aware of certain nutrients the whole time, but it was a really bad time in my life. I am left with the impression that my body svengalied the pregnancy to keep the baby healthy at my expense.
That’s just a belief but I share it in part to remind you that you’re in this for the long haul...there are risks to excess weight but it’s not the whole story of health.
The weird eating and all the illness also messed me up and I gained more weight. However, the year before my third pregnancy I got it off and my last pregnancy was textbook on/off and currently, fingers crossed, I’m at a healthy average weight and enjoy my body lots, at the edge of 50. Life is long! The habits you are forming now will be great after the baby comes too.
posted by warriorqueen at 5:40 AM on August 17, 2020 [2 favorites]
I can just share some anecdotal experience - my first child died a few days after birth and I got pregnant about 9 months later; I was still carrying about 15 extra lbs and my BMI (I know, I know) had me just into the overweight category. I did try to gain weight and for some reason (nothing came up with thyroid results etc.) I could not gain any. My obstetrical team didn’t really believe that I was eating and I had to keep a food diary. For a while I was eating 4500 calories which was gross.
Anyways, the point is they really monitored fetal growth via ultrasound and my son did have growth issues, measuring quite small and eventually weighing in at 5lbs6oz at delivery. He actually did fine overall although he lost some weight initially and it was worrisome.
For me though, bearing in mind that I was also in a strange emotional space with grief, I was *really* sick for 2 years. I had mastitis twice, I caught every cold, I came down with pertussis when my vaccine failed, and I had shingles. I have a family history of osteoporosis so I was being pretty aware of certain nutrients the whole time, but it was a really bad time in my life. I am left with the impression that my body svengalied the pregnancy to keep the baby healthy at my expense.
That’s just a belief but I share it in part to remind you that you’re in this for the long haul...there are risks to excess weight but it’s not the whole story of health.
The weird eating and all the illness also messed me up and I gained more weight. However, the year before my third pregnancy I got it off and my last pregnancy was textbook on/off and currently, fingers crossed, I’m at a healthy average weight and enjoy my body lots, at the edge of 50. Life is long! The habits you are forming now will be great after the baby comes too.
posted by warriorqueen at 5:40 AM on August 17, 2020 [2 favorites]
Two reasons -
1) restricting calories can put stress on your body at a time when your body is already working double time. This is particularly true because most diets mandate a fixed number of calories every day, when your appetite and needs can fluctuate quite a bit throughout the pregnancy. Some women can hardly eat at all in the first trimester and then make up for it, some vary from week to week (me!).
2) putting on less weight during pregnancy increases your risk of having a baby that is underweight relative to gestational age. Underweight babies are more likely to have complications after birth.
That being said, it's pretty generally accepted that eating healthy and exercising during pregnancy is a good thing. If you're doing that and you don't gain, then that's probably fine. But restricting and getting focused on the number can have bad consequences.
I'm glad you're talking to your doctor/ nutritionist because they should be able to help you figure out what your body needs.
posted by oryelle at 5:45 AM on August 17, 2020 [6 favorites]
1) restricting calories can put stress on your body at a time when your body is already working double time. This is particularly true because most diets mandate a fixed number of calories every day, when your appetite and needs can fluctuate quite a bit throughout the pregnancy. Some women can hardly eat at all in the first trimester and then make up for it, some vary from week to week (me!).
2) putting on less weight during pregnancy increases your risk of having a baby that is underweight relative to gestational age. Underweight babies are more likely to have complications after birth.
That being said, it's pretty generally accepted that eating healthy and exercising during pregnancy is a good thing. If you're doing that and you don't gain, then that's probably fine. But restricting and getting focused on the number can have bad consequences.
I'm glad you're talking to your doctor/ nutritionist because they should be able to help you figure out what your body needs.
posted by oryelle at 5:45 AM on August 17, 2020 [6 favorites]
Response by poster: Not going to threadsit, but I feel like I need to emphasize that I am not going to diet or restrict my calories to any fixed number. It's just that I've begun tracking my food so that I'll have information to show my nutritionist, and it averages out to about 2000. That is apparently how much I eat when I eat healthy foods instead of garbage.
My thinking was simply that if I was eating a garbage diet of, say, 2500 kcals a day before, and it resulted in my currently overweight body, then switching to a healthy diet that naturally contains fewer calories and becoming more active should result in some weight loss. And it seems counterintuitive to me that I need to actively work to prevent that, to gain weight even, when I am already overweight.
posted by piranna at 5:55 AM on August 17, 2020 [2 favorites]
My thinking was simply that if I was eating a garbage diet of, say, 2500 kcals a day before, and it resulted in my currently overweight body, then switching to a healthy diet that naturally contains fewer calories and becoming more active should result in some weight loss. And it seems counterintuitive to me that I need to actively work to prevent that, to gain weight even, when I am already overweight.
posted by piranna at 5:55 AM on August 17, 2020 [2 favorites]
I've had four pregnancies and four different ob-gyns. They have all told me that people who are overweight do not need to gain weight in order to have a healthy pregnancy. This is also what I learned in nursing school. So its strange that you are hearing the opposite ? Maybe you are responding to the standard advice that people should not actively try to lose weight during pregnancy.
posted by pintapicasso at 6:06 AM on August 17, 2020 [8 favorites]
posted by pintapicasso at 6:06 AM on August 17, 2020 [8 favorites]
Anecdata: I was overweight with baby #2. I gained maybe 2 lbs total - I was totally healthy during the pregnancy - ate a very healthy diet with no calorie restriction.
posted by turtlefu at 6:07 AM on August 17, 2020 [2 favorites]
posted by turtlefu at 6:07 AM on August 17, 2020 [2 favorites]
Best answer: In that case, the focus is on making sure that you do not have a baby that is underweight. I found this quote on Expecting Science:
(4) How much fat you gain may not affect the size of your baby. Note I said fat, not weight. Total weight gain does correlate with the baby’s eventual size; fat gain does not. Greater water and protein gain in the placenta, uterus, and amniotic fluid all predict a bigger baby. More fat mass in your thighs, breasts, and stomach does not.
“Birth weight was positively correlated with gains in weight… but not FM [Fat Mass] gain. Lederman et al. (1997) also found that maternal weight and FFM [Fat-free Mass], but not FM [Fat Mass], at term related to birth weight” — IOM 2009 report, pg. 83
Why, then, do we advise women with a slow rate of gain to eat more, in order to avoid having a baby that is too small? There is no evidence that eating past hunger leads to bigger, healthier babies. Instead, these studies suggest that the arrow of causation goes in the opposite direction–healthy babies tend to promote greater weight gain.
This is also discussed in Emily Oster's Expecting Better, primarily around the risks of having a too-small baby. But it sounds like you can keep doing what you're doing to stay healthy and increase that fat free mass.
posted by oryelle at 6:08 AM on August 17, 2020 [4 favorites]
(4) How much fat you gain may not affect the size of your baby. Note I said fat, not weight. Total weight gain does correlate with the baby’s eventual size; fat gain does not. Greater water and protein gain in the placenta, uterus, and amniotic fluid all predict a bigger baby. More fat mass in your thighs, breasts, and stomach does not.
“Birth weight was positively correlated with gains in weight… but not FM [Fat Mass] gain. Lederman et al. (1997) also found that maternal weight and FFM [Fat-free Mass], but not FM [Fat Mass], at term related to birth weight” — IOM 2009 report, pg. 83
Why, then, do we advise women with a slow rate of gain to eat more, in order to avoid having a baby that is too small? There is no evidence that eating past hunger leads to bigger, healthier babies. Instead, these studies suggest that the arrow of causation goes in the opposite direction–healthy babies tend to promote greater weight gain.
This is also discussed in Emily Oster's Expecting Better, primarily around the risks of having a too-small baby. But it sounds like you can keep doing what you're doing to stay healthy and increase that fat free mass.
posted by oryelle at 6:08 AM on August 17, 2020 [4 favorites]
I was overweight with my pregnancy, and I did not gain any weight, which was not a problem for my doctor. For the first time in my life I felt sated when I ate small-to-reasonable sized meals, an effect which went away after delivery.
Baby was 7 pounds at birth and has been healthy (knock on wood) ever since.
(don't worry about what the internet says - every pregnancy is different and what your doctor says to you is much more important.)
posted by 41swans at 6:22 AM on August 17, 2020 [3 favorites]
Baby was 7 pounds at birth and has been healthy (knock on wood) ever since.
(don't worry about what the internet says - every pregnancy is different and what your doctor says to you is much more important.)
posted by 41swans at 6:22 AM on August 17, 2020 [3 favorites]
My spouse (overwieght) weighed exactly the same at the beginning her pregancy and the day she gave birth. We had a smaller kiddo, she was 5lbs 14 oz, but we are small people. Babysky is healthy.
After the baby was out, she actually wieghed about 20lbs less than she had before her pregnancy. None of her doctors seemed concerned about it during the pregnancy.
posted by AlexiaSky at 8:08 AM on August 17, 2020 [2 favorites]
After the baby was out, she actually wieghed about 20lbs less than she had before her pregnancy. None of her doctors seemed concerned about it during the pregnancy.
posted by AlexiaSky at 8:08 AM on August 17, 2020 [2 favorites]
I was significantly overweight for all my pregnancies, and my doctors were happy with me maintaining my weight or losing slowly, as long as I was eating reasonably. This seemed especially true early in the pregnancy. I think one doctor said that I should expect to gain a few pounds in the last trimester, when growth is happening fast and baby's getting big, but that it would be fine to not gain any early on.
posted by beandip at 8:43 AM on August 17, 2020 [3 favorites]
posted by beandip at 8:43 AM on August 17, 2020 [3 favorites]
OP, you will be perfectly fine if you happen to lose weight because you are eating healthily. (It would be an unusual result, obviously, because pregnancy hormones cause most women to gain weight in addition to the weight of the actual baby and amniotic sac -- swelling everywhere etc - but it could happen.) Plenty of women lose some in the first half because of pregnancy nausea, too.
Don't google. All the stuff you're finding is talking about how one shouldn't restrict calories and nutrients during pregnancy, which is true and obvious. Google results are not tailored to very specific questions like the one you have. Just ask your doctor.
posted by fingersandtoes at 8:50 AM on August 17, 2020 [5 favorites]
Don't google. All the stuff you're finding is talking about how one shouldn't restrict calories and nutrients during pregnancy, which is true and obvious. Google results are not tailored to very specific questions like the one you have. Just ask your doctor.
posted by fingersandtoes at 8:50 AM on August 17, 2020 [5 favorites]
Your body may not be able to make adequate calories, vitamins and minerals available to the fetus if you are not consuming enough calories. I'm sure you know you need folate and are taking a supplement, but other vitamins and minerals as well as calories are needed. Low birth weight is problematic for infants. a dietician may be able to give you qualified advice and documentation.
I was ravenous while pregnant and initially while nursing. I lost some weight in the 1st 6 months of having the baby and nursing. The 2nd 6 months, especially, of nursing, the pounds magically melted away, my son gained weight, and I got back to a very healthy weight. I breastfed my son for about 18 months, comfort mostly at the end, and enjoyed it. The 1st couple weeks of nursing were painful and difficult, then it got so easy. People have different experiences, but that's mine.
Congratulations!
posted by theora55 at 9:03 AM on August 17, 2020 [2 favorites]
I was ravenous while pregnant and initially while nursing. I lost some weight in the 1st 6 months of having the baby and nursing. The 2nd 6 months, especially, of nursing, the pounds magically melted away, my son gained weight, and I got back to a very healthy weight. I breastfed my son for about 18 months, comfort mostly at the end, and enjoyed it. The 1st couple weeks of nursing were painful and difficult, then it got so easy. People have different experiences, but that's mine.
Congratulations!
posted by theora55 at 9:03 AM on August 17, 2020 [2 favorites]
Not going to threadsit, but I feel like I need to emphasize that I am not going to diet or restrict my calories to any fixed number.
I didn't think you were! Just wanted to explain the thinking behind the "you must not lose weight!" commands. I think they're extremely oversimplified.
Anyway, you do you. I think it's awesome that you're motivated to eat healthy, and wish you all the best!
posted by Omnomnom at 9:10 AM on August 17, 2020 [2 favorites]
Anecdata from another overweight mother here (nearly 30 years ago, though). I developed gestational diabetes and was given a food plan by the clinic dietitian. On the very sensible, healthy food plan, which I followed meticulously, I lost about 5 pounds throughout my pregnancy. My mum was panic-stricken ("That's not right! You have to gain at least 15-20 pounds!!") but baby grew just fine and weighed over 8 lbs when he was born. Once he was born, I was 30 pounds lighter than when I became pregnant.
Follow what your medical team advises, but for an overweight woman, not gaining much weight in pregnancy is not a big thing IF she's following competent medical advice, is eating a healthy diet that supports the baby's development, and the baby is growing normally.
posted by angiep at 9:52 AM on August 17, 2020 [3 favorites]
Follow what your medical team advises, but for an overweight woman, not gaining much weight in pregnancy is not a big thing IF she's following competent medical advice, is eating a healthy diet that supports the baby's development, and the baby is growing normally.
posted by angiep at 9:52 AM on August 17, 2020 [3 favorites]
I just completed my first pregnancy this year, and i had a lot of issues and did a lot of googling, and let me tell you....that way madness lies! Everyone has something to say, and most of the time it's at odds with each other and did nothing but raise my anxiety. If you are doing what your OBGYN and dietician advise and they are pleased with both your and baby's health, go with it. And anecdotally, I gained maybe five pounds (probably just fluid in the last month, truthfully) and birthed a nearly 8 pound baby.
posted by BlueBear at 10:40 AM on August 17, 2020 [2 favorites]
posted by BlueBear at 10:40 AM on August 17, 2020 [2 favorites]
Chiming in, four pregnancies while overweight by about 40 pounds. I didn’t gain any weight while pregnant and was about 15 pounds lighter immediately after giving birth (and felt like I gained that 15 pounds back in 24 hours when my milk came in). I was under midwifery care for all pressman use and there was no concerns about my lack of weight gain. Kids were healthy and between 7-8 pounds each.
posted by saucysault at 11:00 AM on August 17, 2020 [3 favorites]
posted by saucysault at 11:00 AM on August 17, 2020 [3 favorites]
When I was pregnant, I started off about 20 pounds overweight. I lost about eight pounds during first trimester due to healthier habits and exercise, but also due to limited appetite. I ended up weighing about the same as I did when I started, by the end of the pregnancy. After having the baby I weighed immediately 14 pounds less.
My obgyn was very not concerned, while I was repeatedly asking her if it was ok and eating higher fat foods to try to get in more calories.
Baby was born at a very good weight (49% if I remember, and above that for height).
Apparently the obgyn did do more sonograms than she would have otherwise just to make sure baby was growing appropriately.
Get your doc's guidance. And if they say you're fine, don't worry too much. Getting gestational diabetes could be more of an issue (just conjecture) so eating healthy is great.
Good luck and congrats!
posted by cacao at 2:13 PM on August 17, 2020 [2 favorites]
My obgyn was very not concerned, while I was repeatedly asking her if it was ok and eating higher fat foods to try to get in more calories.
Baby was born at a very good weight (49% if I remember, and above that for height).
Apparently the obgyn did do more sonograms than she would have otherwise just to make sure baby was growing appropriately.
Get your doc's guidance. And if they say you're fine, don't worry too much. Getting gestational diabetes could be more of an issue (just conjecture) so eating healthy is great.
Good luck and congrats!
posted by cacao at 2:13 PM on August 17, 2020 [2 favorites]
I was overweight when I fell pregnant, gained nothing until the last three weeks when I swelled up like a balloon with water due to high blood pressure/pre-e. My Ob was never worried about my weight - he said it wasn't necessary for me to gain or lose, just to maintain healthy patterns. Between the morning sickness and pre-e, I came out very much thinner after giving birth (7 pounder at 37 weeks), and continued losing weight while I was nursing.
The weight gain from pregnancy is not fat, it's a whole other organ and baby and assorted changes. Losing weight while pregnant means you're actually losing MORE than just what the scale says - because your body has to have the placenta etc and it is compensating. So weight loss during pregnancy is usually, all up, being lost at a rate that can be deeply unhealthy (primarily in terms of vitamin and mineral loss, and muscle or bone density).
Eleven years later I've gained back what pregnancy and nursing lost, but my joints are wrecked, my thyroid and pancreas and liver are monitored due to occasional problems thanks to the pre-e and undiagnosed gestational diabetes. How much of that is from spending the first three months barely getting enough calories let alone vitamins, and the rest of the pregnancy dealing with blood pressure issues and relaxin, I don't know. But I would never attempt to lose weight while pregnant, not when any deficiency between what the fetal needs are and what my intake is literally get yanked out of my bloodstream and bones, and can have long term effects.
posted by geek anachronism at 4:00 PM on August 17, 2020 [1 favorite]
The weight gain from pregnancy is not fat, it's a whole other organ and baby and assorted changes. Losing weight while pregnant means you're actually losing MORE than just what the scale says - because your body has to have the placenta etc and it is compensating. So weight loss during pregnancy is usually, all up, being lost at a rate that can be deeply unhealthy (primarily in terms of vitamin and mineral loss, and muscle or bone density).
Eleven years later I've gained back what pregnancy and nursing lost, but my joints are wrecked, my thyroid and pancreas and liver are monitored due to occasional problems thanks to the pre-e and undiagnosed gestational diabetes. How much of that is from spending the first three months barely getting enough calories let alone vitamins, and the rest of the pregnancy dealing with blood pressure issues and relaxin, I don't know. But I would never attempt to lose weight while pregnant, not when any deficiency between what the fetal needs are and what my intake is literally get yanked out of my bloodstream and bones, and can have long term effects.
posted by geek anachronism at 4:00 PM on August 17, 2020 [1 favorite]
Assuming you do not have an eating disorder and you are in reasonable psychological health (no OCD, no extreme low self esteem, no body dysmorphia, no serious and/or unresolved trauma history relating to food/eating/body),
TRUST YOUR BODY, TRUST YOURSELF, AND FUCK THE MEDICAL ESTABLISHMENT
(also fuck internet folks pregnancy communities who, well intentioned though they may be, collude with the medical establishment in infantalizing and patronizing pregnant people)
- Signed,
a 4'11" woman who used to weigh 135-140 lbs pre-pregnancy, then happily and very healthily gained no more than 7 lbs during both pregnancies due to craving fruits and spinach all the time instead of potato chips, endured FAR too many lectures from my doctor and "interventions" by my family during both pregnancies, suffered zero complications, gave birth to healthy average-weight children and found my post pregnancy weight to be 125-130 lbs literally the day after I gave birth, regained my old potato chip addiction immediately thereafter and went back to 140-150 lbs within a year after giving birth both times in spite of breastfeeding, but never ever ever stopped fuming at all the doctors and family members who condescended to know more about my body and my food habits than I do.
posted by MiraK at 4:42 PM on August 17, 2020 [2 favorites]
TRUST YOUR BODY, TRUST YOURSELF, AND FUCK THE MEDICAL ESTABLISHMENT
(also fuck internet folks pregnancy communities who, well intentioned though they may be, collude with the medical establishment in infantalizing and patronizing pregnant people)
- Signed,
a 4'11" woman who used to weigh 135-140 lbs pre-pregnancy, then happily and very healthily gained no more than 7 lbs during both pregnancies due to craving fruits and spinach all the time instead of potato chips, endured FAR too many lectures from my doctor and "interventions" by my family during both pregnancies, suffered zero complications, gave birth to healthy average-weight children and found my post pregnancy weight to be 125-130 lbs literally the day after I gave birth, regained my old potato chip addiction immediately thereafter and went back to 140-150 lbs within a year after giving birth both times in spite of breastfeeding, but never ever ever stopped fuming at all the doctors and family members who condescended to know more about my body and my food habits than I do.
posted by MiraK at 4:42 PM on August 17, 2020 [2 favorites]
A plan to eat healthy sensible meals at a level of calories need by your body to maintain your health and the growing baby makes perfect sense to me. If you are already overweight and are switching to a healthier lifestyle, you may find that you end up gaining much less than "normal". It sounds like you understand that. Going into this with an intention to use your healthy habits as an opportunity to lose weight can easily cross over into not getting enough for your body + baby. Going into it with an intention to build healthy habits should help you have a healthy pregnancy plus build habits that will help you manage your weight in the months and years to come.
posted by metahawk at 8:28 PM on August 17, 2020 [3 favorites]
posted by metahawk at 8:28 PM on August 17, 2020 [3 favorites]
Best answer: But in the mean time, I'm curious: why is it that every pregnancy-related source I find is telling women they Must! Not! Lose! Weight!
First, as I'm sure you've realised, everyone seems to have an opinion on what you should be doing during pregnancy regardless of their level of expertise and the vehemence with which they will express those ideas is inversely proportional to that level of expertise. (Some of those people will be medical professionals, not all of whom will really be familiar with all the relevant specialist knowledge. A gastroenterologist is much more likely to express an opinion of pregnancy than an ob-gyn is on interpreting the results of a sigmoidoscopy. Why this might be is left as an exercise for the reader)
Second, there is often a big difference between public health advice and what the science strictly speaking supports. Messaging which is intended for everyone is usually written assuming that the dumbest, most ill-informed person in the audience is going to read it, interpret it through their own previous beliefs, and use it to direct or justify their actions.
Anyone writing such advice will know that there is an incredible range of kooky-ass nonsense that people will get up to in the name of weight loss. Humans have had a long evolutionary history of surviving under difficult circumstances so people without body dysmorphias don't usually manage to do much damage to themselves doing this but part of the way that bodies will react to extreme starvation is to divert nutrition away from a fetus which means that things which are ineffective but harmless to non-pregnant people can be harmful to a developing fetus if undertaken by a pregnant person. I'm sure a doctor can advise you on what is safe but I imagine that takes rather a lot more than just eating slightly fewer calories than you had been previously to cause a problem.
If public health or medical professionals write something nuanced about how, depending on your previous weight, the actual diet you're following, and the advice of your doctors, it may not be a problem to lose weight during pregnancy, they know that someone who is already borderline underweight is going to panic about "getting fat" during pregnancy and go on some loopy ultra-low calorie diet which actually does end up leading to low birthweight because "the doctors said it was ok to lose weight". Therefore they play it safe. They know we live in a society that valorises diets and weight loss so they may feel they need to make a definitive statement the other way to make sure that any reader knows that it is ok and normal to gain weight during pregnancy.
See also lots of other messaging around what foods and beverages are safe during pregnancy. Is it really necessary to make absolutely sure that a person in the second trimester doesn't even have a bite of cake containing trace alcohol? Probably not but there is something to be said for the absolute clarity of messaging.
posted by atrazine at 4:18 AM on August 18, 2020 [5 favorites]
First, as I'm sure you've realised, everyone seems to have an opinion on what you should be doing during pregnancy regardless of their level of expertise and the vehemence with which they will express those ideas is inversely proportional to that level of expertise. (Some of those people will be medical professionals, not all of whom will really be familiar with all the relevant specialist knowledge. A gastroenterologist is much more likely to express an opinion of pregnancy than an ob-gyn is on interpreting the results of a sigmoidoscopy. Why this might be is left as an exercise for the reader)
Second, there is often a big difference between public health advice and what the science strictly speaking supports. Messaging which is intended for everyone is usually written assuming that the dumbest, most ill-informed person in the audience is going to read it, interpret it through their own previous beliefs, and use it to direct or justify their actions.
Anyone writing such advice will know that there is an incredible range of kooky-ass nonsense that people will get up to in the name of weight loss. Humans have had a long evolutionary history of surviving under difficult circumstances so people without body dysmorphias don't usually manage to do much damage to themselves doing this but part of the way that bodies will react to extreme starvation is to divert nutrition away from a fetus which means that things which are ineffective but harmless to non-pregnant people can be harmful to a developing fetus if undertaken by a pregnant person. I'm sure a doctor can advise you on what is safe but I imagine that takes rather a lot more than just eating slightly fewer calories than you had been previously to cause a problem.
If public health or medical professionals write something nuanced about how, depending on your previous weight, the actual diet you're following, and the advice of your doctors, it may not be a problem to lose weight during pregnancy, they know that someone who is already borderline underweight is going to panic about "getting fat" during pregnancy and go on some loopy ultra-low calorie diet which actually does end up leading to low birthweight because "the doctors said it was ok to lose weight". Therefore they play it safe. They know we live in a society that valorises diets and weight loss so they may feel they need to make a definitive statement the other way to make sure that any reader knows that it is ok and normal to gain weight during pregnancy.
See also lots of other messaging around what foods and beverages are safe during pregnancy. Is it really necessary to make absolutely sure that a person in the second trimester doesn't even have a bite of cake containing trace alcohol? Probably not but there is something to be said for the absolute clarity of messaging.
posted by atrazine at 4:18 AM on August 18, 2020 [5 favorites]
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Recommendation 2 'Pregnant women', which includes the recommendation that 'dieting during pregnancy is not recommended as it may harm the health of the unborn child', however the new studies identified in this surveillance review suggest there are no harms associated with 'controlled' weight loss during pregnancy.
NICE is quite comprehensive in setting out its evidence base but I haven't dug around further. I suspect that the concerns about the effects of poor nutrition due to crash dieting mean that at a population level that they thought it was not a good idea to change the overall recommendation but you'd need to read more of what they provide to confirm that.
posted by plonkee at 5:28 AM on August 17, 2020 [1 favorite]