Pregnancy: No Weight Gain for Obese Women?
Study Suggests No Pregnancy Weight Gain for Obese Women Who Get Nutritional Guidance
WebMD News Archive
June 2, 2009 -- Women who are obese when they become pregnant may not need to gain weight during pregnancy, as long as they and their doctors focus on healthy eating, a new study shows.
"The take-home message is that you can eat well during your pregnancy without overeating, and pregnancy should not be a license to overeat, and pregnancy should not be a contributing factor to the epidemic of obesity in this country," researcher Yvonne S. Thornton, MD, MPH, tells WebMD.
Thornton's findings, published in the June edition of the Journal of the National Medical Association, go further than the Institute of Medicine (IOM) did in its new guidelines for pregnancy weight.
The IOM recommends that obese women gain 11-20 pounds during pregnancy. Thornton's team argues that obese women may have healthy pregnancies maintaining their weight, provided they have professional nutritional guidance -- and accountability about what they eat.
Pregnancy "is not a time to eat twice as much, but twice as well," Thornton says.
Pregnancy Weight Study
Thornton's study included 232 New York state women who were obese when they got pregnant. The women's BMI (body mass index) ranged from 30 to 69, averaging in the upper 30s.
All of the women got information about nutrition during pregnancy. Half of the women also got a personalized healthy eating program and kept food diaries, which were reviewed at each prenatal checkup. For comparison, the other half of the group didn't get eating plans and didn't keep food diaries.
Thornton says she deliberately didn't use the word "diet" because she considers it "an emotionally charged word" and because the study wasn't about losing weight during pregnancy.
"We're not saying that pregnant women should lose weight. We're not advocating that," Thornton says. "We're saying, 'Forget about the pounds, already ... Let's talk about eating well and whatever happens, happens.'"
Thornton likens the food diary reviews to monitoring drivers' speed.
"If it says 55 miles an hour, you know most of us don't go 55 miles an hour. But if there's a police officer there, we're going 55 miles an hour. And that's the same thing with my study."
For instance, Thornton says a patient told her that she was craving chocolate cake but decided to get fruit instead because she knew she would have to write it down.
Thornton has been in her patients' shoes. Read about her own pregnancy weight experiences, which inspired this study, in WebMD's news blog.
Obesity and Pregnancy: Study's Results
Overall, women who gained less than 15 pounds during the pregnancy were more likely to be in the group that kept the food diaries than in the comparison group, and they were less likely to develop gestational diabetes, preeclampsia, undergo cesarean section, or have labor induced.