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Update on Pregnancy Related Weight-Gain Guidelines

Posted May 29 2009 10:34pm

The Institute of Medicine (IOM) released yesterday an updated set of guidelines for weight gain during pregnancy. Given that Treatment Notes did a two-part look at pregnancy and eating disorders in 2008, (Click here for Part I and here for Part II ) it seems fitting for us to post a link to the updated guidelines here...

For a download-able brief draft of the full report by IOM, click HERE. For a summary, continue reading...

The Institute of Medicine and the National Research Council today released a report recommending new guidelines for weight gain during pregnancy. The report updates guidelines that were last set in 1990 and takes into account changing US demographics, particularly the increase in the numbers of women of childbearing age who are overweight and obese. 

According to Kathleen M. Rasmussen, ScD, professor of nutrition at Cornell University and chair of the guidelines committee, "The earlier guidelines recommended weight gain that would be optimal for the baby. These new guidelines take into account the well-being of the mother as well. This is a fundamental and important change," Rasmussen said at a press briefing where the new recommendations were announced.

The recommended weight gain for each category of prepregnancy BMI appears in the report as follows:

• Underweight (< 18.5 kg/m 2 ); total weight gain range: 28 to 40 pounds

• Normal weight (18.5 - 24.9 kg/m 2 ); total weight gain range: 25 to 35 pounds

• Overweight (25.0 - 29.9 kg/m 2 ); total weight gain range: 15 to 25 pounds

• Obese (≥ 30.0 kg/m 2 ); total weight gain range: 11 to 20 pounds

Upon review, it appears that the most significant changes to the guidelines come with recommended amount of weight gain for overweight and obese women, with little to no significant change in the other categories.

The guidelines, as seen above, call for minimal weight gain in obese women during pregnancy. Reaction from eating disorders experts has thus far been mixed. Even Rasmussen conceded that getting obese women to restrict their gestational weight gain to no more than 20 pounds would be a challenge. However, she commented to one health media outlet, that the suggestions are "do-able". "The studies that we reviewed showed that many obese women gain progressively less weight the heavier they are."

The new guidelines stress the importance of preconception counseling to ensure women of childbearing age are at a healthy weight before they become pregnant. However, Dr. Rasmussen admitted to Medscape Ob/Gyn & Women's Health that the committee did not yet have any data on the success of such counseling.

"These data provide a strong reason to assume that interventions will be needed to assist women, particularly those who are overweight or obese at the time of conception, in meeting the guidelines. These interventions may need to occur at both the individual and community levels and may need to include components related to both improved dietary intake and increased physical activity," she told reporters at the press briefing.

Concern from eating disorders experts centers on the possible impression that some women may gain from portions of the guidelines that can be seen to suggest that some women may be counseled to diet while pregnant. However, reactions to yesterday's new guidelines are still being formulated, so stay tuned for additional information.

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