Can Pregnancy Weight Loss Be Good?
For Obese Women, Losing Weight During Pregnancy May Help Baby's Health
WebMD News Archive
June 14, 2007 - Losing weight during pregnancy may improve the health of
babies born to obese women with gestational diabetes.
Traditionally, doctors haven't liked to see pregnant women lose weight, even
if the women are obese. Indeed, the 1990 guidelines of the Institute of
Medicine (IOM) suggest that obese women should gain 15 to 25 pounds over the
course of a pregnancy.
Yet children born to obese women have increased risk of neural tube defects,
congenital heart defects, and other serious problems. And most women don't lose
all the weight they gain during pregnancy -- adding to the health risks of
women already battling obesity.
This has led some doctors to question whether it might be better for obese
women to maintain their weight -- or even lose weight -- during pregnancy.
One of those doctors is Raul Artal, MD, professor and chairman of the
department of obstetrics, gynecology, and women's health at Saint Louis
University School of Medicine. To begin studying the issue, Artal and
colleagues worked with 96 obese or morbidly obese pregnant women with
Gestational diabetes is diabetes that occurs during pregnancy in a woman who
didn't have diabetes before pregnancy; it usually goes away after
The women in the study were allowed to choose either a reduced-calorie diet
alone or a weight-maintenance diet plus exercise -- walking for at least 20
minutes after each meal.
Nearly half the women in the exercise group maintained their weight or lost
weight, while four out of five women in the diet-only group gained weight.
"Women who either maintain weight in pregnancy or lose weight -- and
exercise -- have fewer complications than those on diets alone," Artal
tells WebMD. "We definitely see these women deliver normal-size babies,
which means that this plays a role in fewer complications."
Does this prove it's safe for obese women to lose weight during
No, says J. Christopher Glantz, MD, MPH, professor of obstetrics and
gynecology at the University of Rochester, N.Y. He notes that the Artal study
was too small and too limited in scope to apply to all obese women during
But the study does suggest that the dogma "weight gain during pregnancy
is always good" should be re-examined, says Glantz, who was not involved in
the Artal study.
"My own experience is the babies do well whether obese women gain zero
pounds or the 15 pounds the IOM recommended," Glantz tells WebMD. "For
women in the higher obesity categories, it isn't a problem even if they lose
Artal stresses the importance of exercise during pregnancy -- particularly
for obese women.
"We know that exercise in pregnancy is safe for everybody," Artal
says. "When we talk exercise, we talk about just walking -- a safe form of
exercise. If obese, pregnant women can engage in walking at a moderate pace, it
is probably more beneficial. And maintaining a lower-calorie diet is
The bottom line, Artal says, is that we all must get over the idea that
pregnancy is a time for inactivity and overeating.
"The message should be that pregnancy is not a state of confinement --
and you should not eat for two," he says.
Artal and colleagues report their findings in the June issue of Applied
Physiology, Nutrition, and Metabolism.