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Eating (Well) for Two

Eating (Well) For Two

A Pregnant Pause on Thinness continued...

"Women get really uptight because for so long they've been fighting to keep their weight in line and now all of a sudden we're telling them to gain this much weight," says Ward. "But if you don't eat enough and gain enough weight, you'll have a baby that could be affected for the rest of its life because you wanted to preserve your figure." Women who don't gain enough weight in pregnancy are more likely to have small babies, and those smaller than 5 ½ pounds have a harder time surviving.

The gain can be especially difficult for those who battle anorexia or bulimia, but often the responsibility of bringing a new life safely into the world is enough impetus for women to overcome their eating disorders, if only temporarily. Puls often recommends keeping a daily planner to record what you've eaten, since eating disorders are often associated with control.

"I was not going to hurt my babies," says one woman, who did not want her name used because she still battles anorexia. During both her pregnancies, she managed to eat three meals a day and get the recommended nutrition. She gained 33 pounds each time, and her babies, both healthy, weighed 8 pounds. "Those are the only times since I was 18 years old that I didn't have an eating disorder," she concedes. Still, it was a struggle, and she obsessed about her weight. "I was really paranoid. But if I was good ... then on the days I weighed in, I'd go to the bakery after and reward myself with a smiley cookie."

If you are either under- or overweight, make sure you've discussed with your doctor or midwife an appropriate weight range to target. Women who start out underweight will probably have to gain more than the average mom-to-be, and those who weigh too much may be advised to gain less, in addition to being monitored for associated problems, such as high blood pressure and diabetes. If you're carrying twins, the American College of Obstetricians and Gynecologists recommends a weight gain of 45 pounds.

Don't get too hung up over every pound, though. "To me, the scale is not the end point," says Puls, who practices with two obstetricians. "The scale is an indicator, and if it's going up too fast then you have to look at nutrition and exercise. If it's not going up fast enough, then you need to look at nutrition. I don't use the scale to say, 'Oh, you gained too much' or 'Oh, you gained too little.'"

And remember: You can get your figure back; it just might take a year to lose all the weight and to regain muscle tone, Ward says. Within six weeks, you'll probably lose 15 to 20 pounds (from the baby, placenta, extra blood volume and fluids), although if you breast-feed, those last pounds may linger until you've weaned your baby. Milk production requires about 800 calories a day, with only about 300 available from stored fat. That's 500 extra calories derived from your diet -- 200 more than you needed while pregnant.

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