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NYTimes — Goal for the Obese: Zero Weight Gain

Posted Dec 15 2009 7:38am

Check out my latest blog post over at WeAretheRealDeal.com, “NYTimes — Goal for the Obese: Zero Weight Gain.” You can also read it here after the jump.

Let me state for the record that I’m not pregnant — but that eventually I’d like to become a mom.

About a year and a half ago on my blog, at the height of my disordered eating issues, I admitted that pregnancy weight scares me quite a bit — but not enough that I would not be willing to embrace it when the time comes.

Since then, fellow WATRD blogger Claire Mysko’s book, Does This Pregnancy Make Me Look Fat, came out and has been a helpful tool for people like me who are working through body image issues; I hope to read it again when I’m pregnant someday.

That said, for most women, the notion of pregnancy weight is daunting — even if you know it’s for a an amazingly good reason.

But what if you were clinically obese and told not to gain any weight during pregnancy? We know obesity carries with it many risk factors, but what would that do to your mind, and to your body? To your baby’s development?

And so reading this article in the New York Times today, New Goal for the Obese: Zero Gain in Pregnancy, really gave me pause.

Per the article:

“One-fifth of pregnant women in the United States are obese, and more and more doctors are advising them to watch their weight if they want an easy pregnancy and a smooth delivery. In May, the Institute of Medicine issued guidelines lowering the minimum recommended weight gain for obese women to 11 pounds, from 15.

Now, a large four-year trial called the Healthy Moms study is going further, trying to keep obese pregnant women from gaining any weight at all. If they do gain weight, researchers want it limited to 3 percent of their baseline weight, about 5 pounds for a woman who weighs 170 pounds…”

“… Restrictions on weight in pregnancy are nothing new: throughout the 19th century and much of the 20th century, women were told to gain less than 20 pounds to reduce the risk of complications and Caesarean deliveries. The guidelines were relaxed in the 1970s and ’80s as Caesareans became safer and the risks to underweight babies were discovered.”

“Rising rates of obesity are now leading experts to question that wisdom. Researchers are beginning to ask whether obesity in the mother may be unhealthy for the developing fetus — and, in turn, whether it could lead to obesity in children. Putting the brakes on weight gain during pregnancy may be an opportunity, in other words, to break the cycle of obesity.”

“But the implications of severely restricting weight are not entirely known. “It’s an experiment,” Dr. Rasmussen said of the $2.2 million trial, which is receiving federal financing. “We need experimental studies that can really show us that if you have women gain within a certain limited range, that will improve their outcomes.”

I’ll be curious to see more results of this Healthy Moms study.

For example, “Ms. Paten, of the Bronx, did well with her pregnancy, but she had high blood pressure and gestational diabetes throughout it and delivered by Caesarean section, despite her weight maintenance. Her baby, Brandon, who was born on Sept. 4, weighed 8 pounds 3.5 ounces. After Brandon was born, she tested free of diabetes, though more checks are needed. And she has lost 22 pounds.”

While I don’t necessarily believe a woman who is 100 lbs overweight is doing her body any good by gaining an extra 35-40 lbs. during pregnancy, my fear is that severe restrictions like this could lead to more cases of pregorexia.

And there are other concerns, too. “What we don’t know is: Are there effects on the babies’ neurological development, or other adverse effects, from women not gaining weight?” Dr. Stotland said. “Some of these women may be losing fat mass, and the question is: Is losing fat mass during pregnancy, when you’re in a higher B.M.I. category, is that safe for the baby?”

I’d love to know your thoughts after you’ve read the article in full.

How about you? Do you think these are good recommendations? Were you (or was anyone you know) ever under doctor’s restrictions not to gain “too much” weight during your pregnancy? How did that affect you mentally?


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