Hormones and (no) weight gain
September 11, 2017 10:24 PM   Subscribe

I'm worried that my inability to put on weight will negatively affect my health in any future pregnancies

(This is all very, very hypothetical, but even still I would like to keep this anon. I'm hoping to get advice/stories from those who had similar situations.)

Background--I can't gain weight for the life of me. I'm a late-20s woman who loses weight quite drastically whenever I get sick, and then struggle to put it back on. I'm still 4-5 kilos below my normal/desired weight after getting sick two years ago, despite many varied attempts to make any progress. I'm also susceptible to vomiting whenever I get even the slightest bit of nausea, which certainly doesn't help in keeping on weight.

I've also never been able to attribute any weight gain to hormonal birth control. I've been on two types over 10 years, and nothing. Other medications (SSRIs, etc.) that commonly cause weight gain have not caused me to gain weight at all.

I feel like these preexisting issues will foreshadow a very nasty 9 months should I decide to have a biological kid, and I'm worried that this could also put me at risk for hyperemesis gravidarum. To make matters worse, I recently confirmed that when my mother was pregnant with me, she was nauseated nearly all day for the entirety of it. But she gained too much weight, and I'm scared of losing it. She apparently was able to snack during the day, but when I'm nauseated I can barely keep anything down.

On the face of it, it really doesn't seem like going through pregnancy would be a particularly sound and healthy choice. But I don't know, maybe in the next few years my body will sort most of these problems out? Maybe I'll have a unicorn pregnancy with no issues at all (ha). Or maybe I should start researching adoption over the next few years?

To summarize my worries:
-I lose weight easily, esp. when sick
-it is extremely hard for me to put on and keep weight, even with hormonal medication
-I tend to vomit when nauseated and lose weight from that (most of it is water weight at first, but still hard to regain what I lost)
-current BMI of 17
-horse pill vitamins upset my stomach
-family history of long-lasting nausea during pregnancy

Does this sound like you? What did you do about it? Were you miserable for 9 months or did you decide not to go through with a pregnancy at all?
posted by anonymous to Health & Fitness (18 answers total) 3 users marked this as a favorite
These all sound like great questions for a doctor - of which I'm not - but I do remember raising similar sounding questions about being in ill health and how it would affect my pregnancy. As a general rule, my obstetrician basically told me that babies are very succcessful parasites and will take whatever they need to grow from their mother with little regard to how it effected her.

Which is why my friend was skeletally thin with bowel cancer during pregnancy but her twins gestating at the time were putting on weight quite well, they just took what they needed. And my boyfriend was a very healthy baby, while his mother had teeth that basically disintegrated because the baby leached all the calcium from her body (this was before mothers were told to take supplements.) Incidentally, both these mothers are fine now. I don't know the finer points about hyperemis gravidarum though or if there's even a link between failure to gain weight prior to pregnancy and this condition during pregnancy.

Edited to add this came across scarier than I meant. To reassure you, the babies all turned out fine, even though the pregnancies especially the first weren't ideal and the mothers were fine as well.
posted by Jubey at 11:06 PM on September 11, 2017 [1 favorite]

I can only respond to this:
-horse pill vitamins upset my stomach

They make gummy prenatal vitamins now. They are like candy.
posted by Toddles at 11:35 PM on September 11, 2017 [4 favorites]

You can see a doctor about your weight. You may get a referal to a dietician as well. Dietitians are trained to help people gain weight.

Also, different vitamins, even big prenatal ones, may not make you ill. I tried one that made me sick and another was fine.

I do know underweight people who've had healthy pregnancies. But I'd consult with your doctors before worrying or making a decision. Most pregnant people are pretty miserable for several months of the pregnancy, so being sick for all 8 is not horribley different. Unfortunately pregnancy is pretty uncomfortable for most expectant mothers. I'm not sure why our society makes it seem joyous (disclaimer, the kid is worth it).
posted by Kalmya at 11:45 PM on September 11, 2017

I do not have your body type or history but I did have a pregnancy where I could not gain weight. I was eating ridiculous amounts of food including protein powder laden whole milk and other bizzaro-world (for me) foods, once I could eat. I gained 11 lbs the whole pregnancy and that was hard, hard won and almost all at the end; after delivery I weighed less than at the start.

Baby is 12 years old now.

I would consider seeing a high-risk ob or a reproductive endocrinologist to talk over your concerns, if you can access one. But it can be ok.
posted by warriorqueen at 11:48 PM on September 11, 2017

Have you ever tried figuring out if you've got food intolerances? Some food intolerances can affect how well you absorb nutrients from food, which can affect your ability to gain weight. Untreated food intolerances can also affect your ability to get pregnant, because I think your body needs to be getting enough nutrition to not make it think you're in a period of food scarcity.

One of the strange things for me about being pregnant though was that my weight gain seemed totally divorced from what I did on a daily basis. What I mean is: the baby grew on his own schedule and my body adjusted to his schedule, and a lot of the time, it felt like I had very little control over how/if I gained weight. It's really a different animal than regular weight gain.
posted by colfax at 12:08 AM on September 12, 2017 [2 favorites]

I'm like you, except without the family history of nausea. Same BMI, even. I had my kids at 33, 35, and 37, gained 30 pounds each time, and returned to pre-pregnancy weight after about a year.

While family history is a risk factor for HG, what you're describing from your mom doesn't sound like it. Remember too that time and hormones can make mothers unreliable narrators:)
posted by snickerdoodle at 3:52 AM on September 12, 2017 [1 favorite]

A friend had very bad hyperemesis gravidarum and lost significant weight. At one point, 3 months in, she was talking with a nurse and was asked what she could eat. "I can lick saltines and drink blue gatorade." The nurse replied, "OK, we can work with that."

Mother and baby are healthy, nearly a year post-birth.

People can go through rough things--but you just need medical support before and during the pregnancy. So talk to professionals.
posted by flibbertigibbet at 5:29 AM on September 12, 2017 [4 favorites]

This sounds very hypothetical but how would you feel about possibly taking something to curb your possible nausea? If you got pregnant and had morning sickness, there are pharmaceuticals for that. They have pros and cons that you can evaluate and I can't tell you how big the pills are but that's a possibility. There are different drugs but one is also frequently prescribed for those who are nauseous as a side effect of treatment for cancer.

It seems like a lot of pregnant women who could take something for nausea don't under the assumption that taking any drugs is harmful for the baby. Personally I thought that feeling miserable for months would be harmful for me and therefore also the baby but my nausea was never that bad.

My two cents: a lot of skinny women have healthy babies. A lot of women who get sick while pregnant have healthy babies. That doesn't mean that you will, can or should have a baby but I wouldn't rule it out if that's something you want based on the information you have shared.
posted by kat518 at 5:39 AM on September 12, 2017 [1 favorite]

I've never been pregnant and I'm no longer underweight. Until I became very ill it looked as though I'd never gain weight. Then, within I think 3-6 months, I gained about 30 pounds, and I have managed to keep about 15 of them. The women on my father's side of the family get chided sternly for not gaining enough weight despite their efforts to eat all the things, and then deliver babies that look like, well, the babies are fat. Not chunky. Not roly poly. Fat.

My background isn't meant to suggest that illness will help you, just to show you my background that's pertinent. I was told by a doctor when I was a kid that is never get big enough to have a baby. Who says shit like that to a kid? He was wrong, but even if he hasn't been, wtf dude? You are not alone in experiencing a very cultural obsession with whether women are making babies "correctly." The particular anxieties you're having, I think, are linked to a broader cultural stance that women are doing it wrong, and fear of hurting a baby or being unable to carry a pregnant to term are fairly common. I won't promise that you'll have a healthy baby. I will say that it's unlikely to be your "fault" either way.

In a viable pregnancy, the baby takes what it needs from the mother. Some things you can do now are have your iron, bone density, and vitamin D checked and work with your medical team to correct any imbalances. Many medical professionals suggest taking pre-natal supplements a yes or more before attempting to get pregnant. Some say that women of child bearing age should always take them "just in case." Mom's weight gain can be a proxy for other things, but not a guaranteed indicator. Emphasis placed on mom's weight gain in either direction can be stressful. Find an ob gyn now that you trust and can develop a good rapport with. Watch the business of being born, and the sequel (both by Rikki Lake) and maybe listen to the birth hour, which is a podcast of interviews with people (only women so far, but I'm hopeful they'll get a man at some point) who have given birth.

I guess what I'm saying is that pregnant and birth are different for everyone, and for many women not gaining weight is more or less of a concern. You're doing absolutely the right thing, getting more information about possible outcomes and alternative ways to manage nutrition and anxiety, both of which are good things to manage.
posted by bilabial at 6:02 AM on September 12, 2017

Not to be alarmist, But your weight can actually impact your fertility and ability to ovulate and get pregnant in the first place. I know when my BMI was near there, I lost my cycle completely.

Are you on bc now? If so, Hormonal bc may actually be regulating your cycle. Without them it may be irregular, or not happen at all. So, number one thing to do is get thee to a doctor. Lack of ability to gain wieght, and regular nausea are an issue to see a doctor for regardless if you want to get pregnant or not.

Lots of people do have pregnancies at low weights and everything turns okay. There are lots of ways to control nausea , vomiting and ways to attempt to gain weight.

It may require extra flexibility and determination to figure out what will work for you during pregnancy. But it is far easier to try and get a handle on things not pregnant so see a doctor and try to add a few kilo.
posted by AlexiaSky at 6:05 AM on September 12, 2017 [1 favorite]

My normal weight is fine, but during my pregnancy I had hyperemesis, and lost a lot of weight which I struggled to put back on. My tips
- gummy vitamins.
- I took diclectin, 3 pills a day up to delivery. If you want to learn about drug options, the Toronto sick kids hospital has an excellent website at motherrisk.com (I think? I'm on a phone)
- I saw a prenatal dietician.
- I spent time in the hospital, 3 times, and got iv hydration sometimes
- I had an amazing high risk OB.

It wasn't the nicest time in my life, but my twins were born healthy at 36 weeks. (And I got to wear my regular clothes 1 week after they were born... most of the weight I gained was baby.)
posted by Valancy Rachel at 6:39 AM on September 12, 2017

I have a hard time gaining weight too and it did not impact my pregnancies, beyond my first OB harassing me to eat more during my first trimester. Luckily my husband was there and he confirmed my version of the story, which is that I eat a crap ton of food thank you very fucking much and the OB let it drop. I gained normally in the third trimesters and had two nine and a half pound babies. I then got accused by most nurses of having gestational diabetes (I didn't), so there's no winning. I lost the weight very quickly, though my body shape changed.

If you are concerned that your weight may have impacted your fertility, I suggest you start tracking your cycle with basal body temperature measurements to make sure you're ovulating. There's no reason to think you're not until there's a problem, though! Taking Charge of Your Fertility is a great book and it might help put you at ease.

There are medications for bad nausea and you should take them. Diclegis worked for me, though the nausea mostly subsided by the end of the second trimester. Didn't stop me from eating, though it did make me want nothing more than fries right out of the oil.

You don't even need to take prenatal vitamins, just folic acid supplements (which are a tiny pill!). I'm allergic to cobalt, which is in methylcobalamin (B12), and my doctors were all perfectly happy with me not taking a pre-natal. Our nutrition is good enough these days that it doesn't really matter.
posted by lydhre at 6:46 AM on September 12, 2017

You seem to have a pretty thorough take on your own issues with weight and difficulty with food. But I don't hear where you've worked with a doctor on this. It also sounds like you are catastrophizing a little bit and I don't blame you because having food issues is very stressful! We have to eat to live and when that's not working well it will dominate your thinking. If you haven't sat down with a trusted doctor, get on that. Be plain: I would like to have a baby and I have lifelong issues with food. My weight feels unhealthy and I am constantly nauseous to the point of vomiting. I need to find some solutions, what are my options and how do we do this?

Consider also seeking out a therapist who specializes in food issues. You'll need to be clear that you have physical issues and that you're not bulemic or anorexic but also know that mind and body are one.

Good luck! I think you are on the right first step but I want you to get the answers for yourself first before getting wrapped up in dark pregnancy thoughts. Because after pregnancy, you'll have an infant to care for and these issues you are having now are going to be even less fun with a baby to care for.
posted by amanda at 7:40 AM on September 12, 2017 [2 favorites]

I've had somewhat similar experiences, but not nearly to the same extent: If I continue normal meals, snack continuously all day, and then have a 500 calorie evening smoothie, I'm going to gain weight.

It's unclear what you mean by "many varied attempts to make any progress," but the general rule applies: If you have a health issue that has persisted for two years and nothing you are doing works, check with a health professional.

I can think of four general possibilities:
1) You eat until you feel full, and you don't gain weight. I doubt it's that simple, but if it is, you just have to eat when you are not hungry.
2) You're sure that you're running a caloric surplus, but you are not gaining weight. That suggests that your body is having trouble absorbing nutrients, and you should see a doctor.
3) You cannot eat enough because it causes gastrointestinal problems. In that case, check with a nutritionist and/or doctor.
4) You are not eating enough calories because you are worried about eating "unhealthy" food, like ice cream and soda and are sticking to less calorie dense foods. Again, consult with a nutritionist.
posted by Mr.Know-it-some at 7:51 AM on September 12, 2017 [1 favorite]

-horse pill vitamins upset my stomach

As other people have said, there are gummy vitamins now. And for when you're pregnant, the most commonly-prescribed pills are pretty small. Dicletin is, in particular, eensy bitsy tiny to the point where I may have lost a couple down the drain at some point.

As a side note, you may not take after your mother in pregnancy stuff. I basically look like my mother and had menstrual cycles just like hers and took a while to conceive, just like her, but she never had any nausea whatsoever and never went into labor, delivering both her kids by c-section at 40+ weeks because my sister and I were just like, chilling and maxing. Meanwhile, even though I'm built nothing like her, I apparently take after my tiny, 100 pound paternal grandmother who puked her way through at least five pregnancies in post-war Hong Kong.
posted by joyceanmachine at 8:12 AM on September 12, 2017

I would see a doctor and get blood tests to see if your nutrition is okay. Even if you don't gain weight, your body may be getting the nutrition it needs.
posted by theora55 at 9:46 AM on September 12, 2017

In my first pregnancy I only gained ten pounds or so and the baby weighed over 8. The only thing my lack of weight gain affected was, I think in retrospect, my milk production. He's now 44 and 6 ft 3 so I don't think it had much of an impact on him.

Just because your mother had problems does not mean you will. My mother and her only sister both did, my sister and I had no real problems, just very minor morning sickness in early pregnancy.

Don't worry yourself sick, you may eventually have super-easy pregnancies, or not. Be as healthy as you can before you conceive and go from there.
posted by mareli at 11:20 AM on September 12, 2017

anonymous posted">> I don't know, maybe in the next few years my body will sort most of these problems out?

I was super-skinny in my twenties, but pretty much on my 30th birthday my metabolism slowed down overnight (just as my doctor had predicted) and I started putting on weight. So, yeah, your body actually might figure these things out.
posted by The corpse in the library at 2:15 PM on September 12, 2017

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