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Too many women are starting pregnancy carrying too many pounds and are gaining too much while they're pregnant, according to a new report by the Institute of Medicine (IOM).
To counter this trend, the IOM has changed its pregnancy weight gain guidelines, which advise obese women (who have a BMI over 30) to gain a minimum of 11 and no more than 20 pounds during pregnancy. Previously they were advised to gain 15 to 25 pounds.
The institute's recommendations, which are the gold standard used by OB/GYNs, remain unchanged for overweight, healthy and underweight women. Overweight women are classified as having a BMI of 25 to 30 and are allowed to gain 15 to 25 pounds. Women at a healthy weight are classified as having a BMI of 18.5 to 24.9 and are allowed to gain 25 to 35 pounds. Underweight women are classified as having a BMI below 18.5, and should gain 28 to 40 pounds. (Weight categories are based on the World Health Organization's body mass index calculations.)
This new recommendation is meant to avoid and alleviate many of the complications that obese women face during pregnancy--namely conditions like preeclampsia and gestational diabetes. Obese women are also more likely to undergo cesarean section than healthy weight women, and children born to obese moms face a higher risk of obesity later in life.
Ellen J. Landsberger, OB/GYN, of Montefiore Medical Center in New York City, says that just as in everyday life, "healthy nutrition, monitoring calories and not having excessive weight gain is very important" during pregnancy.
To help more women stay within these parameters--39 percent of healthy-weight women gain more than the recommended amount, as do 59 percent of overweight women and 46 percent of obese women, according to the Centers for Disease Control--the IOM recommends that doctors educate women so they know what they should be gaining, and encourage them to attain a healthy weight before they become pregnant.
"Preconception counseling is important for women with high blood pressure, lupus, diabetes and now obesity," Dr. Landsberger says. "This puts obesity on the map as a medical problem."
But what does that mean if you're pregnant and have already gained too much weight? "I don't want any pregnant woman to start dieting," says Elizabeth M. Ward, R.D., author of Expect the Best: Your Guide to Healthy Eating Before, During, and After Pregnancy (Wiley, 2009). "Intentional restriction of calories is never a good idea during pregnancy."
Instead, pregnant women should try to adhere to the recommended weekly weight gain goals--1 pound per week in the second and third trimester if you are underweight or healthy weight, and about a half-pound per week if you are overweight or obese, says IOM report co-author Anna Maria Siega-Riz, associate professor at the School of Public Health at the University of North Carolina-Chapel Hill.
Ward says that two or three visits with a nutritionist can help pregnant women control their weight gain.
"Even to gain 11 pounds, you need more calories," Ward says. "I would figure out how many more calories the woman needs and spread it out over time. I would ask her OB if it's okay for her to walk. There's no reason to think a woman with a BMI of 32 can't have healthy pregnancy."
--Cynthia Ramnarace
The new guidelines recommend that overweight women gain no more than 20 pounds during pregnancy. Would you have met these guidelines during your pregnancy? Are these realistic weight goals for most women? Tell us what you think.
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While I understand the purpose of trying to recommend woman do not gain too much weight while pregnant, trust me I've been there, done that, the article is not accurate. Women with a BMI of 25 - 29.9 are not considered obese, they are considered overweight. Women with BMI's over 30 are considered obese. I'm 7 pounds over my target BMI and I would hardly consider myself obese.
The article lists both overweight and obese women as having a BMI between 25 and 30.
I was told that when you gain alot of weight during pregnancy its hard to lose it afterward. I gained 70lbs with my son and lost all of it within a year. And im pregnant again 4 yrs later with a girl and due in 2 weeks, and went from 135 to now 204. and i know i will lose it again. my son was 8 lbs and im sure my daughter wont be much bigger than that if she is. i dont have gestational diabetes or preclampsia, its just what my body does i guess. every women is different and i have hearing that your only supposed to gain 2 to 30 lbs during pregnancy.
Well, i agree as i gained 15 kgs when i was pregnant and now its been like two years and i am still fighting to take it off, its better not to put on too much as it will stretch the skin and when u lose it , your skin is like a bag with you, so keep off the weight is a good thing to do.
Well I gained 14kg, and my BMI is 28 and I lost all 14kg in 11weeks after the birth. My son is now just 14 weeks and I am below my pre-pregnancy weight. However, with my first child I put on about 20kg's and to this day (5yrs on) I am still carrying that weight,. I think it is just how your body deals with each pregnancy.
I do understand the purpose of the article but on the other hand I don't agree with all the weight restrictions, I am pregnant with my 4th child, I have a normal BMI of 20, and with the other 3 I gained 50lbs for all, and with proper exercise and diet after the pregnancy I managed to loose all the weight I gained during the pregnancy's. I am constantly hungry when pregnant and don't want to deprive myself of that because if I get too hungry I feel very nausious. I am sure the same would go for someone who is obese or overweight.
I just believe everyone is different and will gain and loose depending on their body and what is done after the pregnancy to get back to each persons "normal" size.
I'll be perfectly honest... I think that weight recommendations are completely ludicrous for the majority of people. For those with a health concern of sorts, I agree that they need to be careful with weight gain. However, in the time before scales, women kept track of their health depending on how they felt, their energy level, etc., not by how much weight they gained. I really believe that if we stayed away from weighing ourselves and just kept to noticing how we actually feel, we'd be a lot better off. Too much focus is on weight gain, and it's getting old hearing about it. It's not about how much one weighs, it's about what kind of food they're eating and how healthy of a lifestyle they're living.
I am on the "thin" side and gained exactly 47 pounds when I was pregnant with both my girls. Six weeks postpartum, I was back in my regular jeans... and about 3-4 months after the birth, I was back to my pre-pregnancy weight both times. And while I gained nearly 50 pounds, the consistent comment I got was, "Holy cow, did you even come close to gaining 25 pounds?"
I ate extremely healthy, exercised for an hour almost daily, and still managed to gain all that weight. Both my girls were over 8 pounds, and my midwife simply told me that as long as I was doing all the right things, it didn't matter how much I gained. My body would gain whatever it needed to cook a healthy baby.
Really, the focus shouldn't be on how much weight a woman is gaining, but the way in which she is gaining it during pregnancy. Is she filling up on potato chips and soda? Okay, then that's not going to be good or healthy. But as long as she's eating right and taking care of herself, leave her alone about how much she weighs.
Pregnancy is hard enough without having fingers pointed at you and hearing critics say you're too fat.
I am very overweight. I was 245 when I became pregnant. I only gained 15 lbs, five of which I lost the week before she was born 3 weeks early because the preeclampsia became so bad. I am glad that I stuck to the guidelines because my daughter could have been born even earlier if I had and she had enough problems being born just slightly early.
I am normally offended but people blaming everything on weight but when it comes to the safety of the baby I think you should do what is best. I was actually so overcautious about weight gain, I kept being told to gain more because I would go for weeks without weight gain. The only reason I hit those 15 lbs was the swelling from the preeclampsia. I left the hospital weight five lbs less than before I was pregnant.
Anyway, my point is I think the guidelines are good because they are for your safety and your child's safety.
Too much emphasis is placed on the number on the scale during pregnancy and not the nutrition. I am obese according to the BMI and I simply focused on the nutrition not the numbers. I ended up gaining 35 lbs but within a week of giving birth I was 5 lbs below my pre-pregnancy weight. My daughter is one of the healthiest kids her doctor has seen and no one believes me when I tell them how young she actually is because she is so far ahead of other kids her age in mental and physical milestones. Before accusing heavy women of endangering their babies because of numbers, shouldn't we be pointing fingers at those who survive on a fast food diet during pregnancy, overweight or not?
I am 25 years old and my weight is 33 kgs. I am pregnant 2 months. What is the weight i am supposed to gain every week?
Im Obese and pregnant wigth my second child, i lost weight with my first (2 stone/28 pounds) and am 20 weeks pregnant and already lost a stone.
Cant complain that i eat all the wrong stuff while pregnant.
I work in a fast food resturant and you should see what some people feed themselves and their children. Theres should be laws on the amount of fatty food people eat coz seriously theres some people that feed their kids fast food 5-6 times a week, and after walking home i see them in the chippy, or the pizza place. Its disgusting.
So before they try to make OBESE women feel even more worse about themselves maybe they should look at everyone not just a minority.
I am 17 years old and my daughter is about 5 1/2 months old now. I was 15 when i got prognant with her and i was only 180 pounds, and for me that is really good. And when i was 8 months i was 220. She was not a very large baby too she was only 6 pounds 15 ounces. I had to find out that my doctor said that i am overweight by obtaining my medical records from Vernon Jubliee Hospital. Now it is so hard to lose the weight because Lily-Rose keeps me so busy, and i go to school so it is very tough. Lily is very very smart, she is eating baby food, crawling like a mad man and she is sitting up by herself, all at five and a half months.