Weight Control After Pregnancy
Medical Author:
Carolyn Janet Crandall, MD, FACP
Medical Editor:
William C. Shiel Jr., MD, FACP, FACR
Medical Reviewing Editor:
Melissa Conrad Stoppler, MD
Weight control is a widespread concern for many women
after pregnancy. Although common during pregnancy
, weight gain of 30 pounds is difficult for many
women to handle emotionally. Many women are unclear about how to separate fact
from fiction regarding this "post-pregnancy" weight control.
First of all, women need to understand how much weight gain is actually
"normal" during pregnancy. About 15-30 pounds is the wide range of
what is considered reasonable. This may vary according to how heavy a woman is
before she becomes pregnant. A heavier woman may be advised to try to stay
within the lower end of the weight gain range during pregnancy.
Second, there seems to be a myth that weight loss after pregnancy can only be
successful if it occurs rapidly. Somehow, many women feel that if they have not
lost all the pregnancy weight by 1 year after delivery, something is wrong with
them, they are not normal, or they have failed in some way. Actually, the truth
is that weight loss after pregnancy can take a very long time, sometimes a few
years, without signifying that something is wrong. Gradual weight loss is the
norm, not the exception, and the rate of weight loss depends on several factors,
such as whether there were complications with the pregnancy or delivery.
Pregnancy complications can make a woman feel weak or interfere with her
mobility. Certain diseases like postpartum inflammation of the thyroid gland
(thyroiditis), which is a common complication that shows itself soon after
delivery, can cause massive weight struggles if they are severe. Other factors
include whether the woman has other medical illnesses or takes medications that
make weight loss difficult in the first place (whether after pregnancy or at
another time in her life).
Third, there is myth about what is the best method for weight loss after
pregnancy. A myriad of factors contribute to this confusion, beginning with the
fact that there is not enough research about what type of weight program is safe
for the mother (especially the nursing mother) after delivery. This lack of
research, in turn, means that doctors are reluctant to allow any "radical
diets." As a result, less stringent diets are recommended that may take
longer to work and are thus less appealing and too frustrating to many women.
What should a woman consider the best plan for weight loss after
pregnancy?
First, the woman should first have realistic expectations
about how long it takes to lose weight. About 1-2 pounds per week is actually
successful! She should also remember that no specific diet has been proven to be
more safe or effective than any other, and that she likely cannot risk feeling
ill from depriving herself of certain nutrients on radical fad diets. In
addition, if she were nursing, she wouldn't want to harm the baby's nutrition by
potentially dangerous or severely restrictive diets. Initially, a woman should
try to lose the weight on her
own by eating a sensible, balanced diet.
Exercising every single day,
even if that exercise is just walking, is an absolute must. The lack of exercise
is what often holds up the process. Weight loss will simply not be satisfactory
if exercise is lacking. This is true for many reasons; including that exercise
helps keep the body's metabolism from decreasing excessively while dieting. Weight loss while dieting
is easier with exercise and very difficult without it.
If a woman's efforts fail, meaning she has been trying the methods reliably
for a year, including the daily exercise, she may need additional help. For
instance, she may require and evaluation for medical conditions predisposing to
weight control problems (such as thyroid abnormalities, which are common after
pregnancy). Although there are vastly different approaches to weight control,
all weight experts believe strongly that diet plans have to be individualized if
a woman plans to maintain the weight loss. Individualized plans are the only way
to get around the specific food preferences, eating triggers, and time
constraints that each woman will have. (This explains why group weight reduction
plans will frequently produce initial weight loss, but are usually followed by
rapid weight gain. They do not address individualized eating programs that are
tailored specifically for each woman to maximize her chances of keeping the
weight off.) Consulting a dietician is an optimal way to obtain an
individualized plan. The dietician will review key issues, such as the woman's
food preferences, what triggers her to eat, who prepares the meals, and the
details of her schedule in order to create an individual plan. Additionally,
while a woman follows the dietician's plan, she needs to keep up daily exercise
to optimize her weight loss.
Finally, expectations need to be realistic. We are only human. Rapid weight
loss will not stay off, but rational weight loss (1-2 pounds a week) can stay
off. And, remember that the biggest predictor of maintaining weight after the
weight loss phase is keeping up exercise. You can do it!
Last Editorial Review: 10/26/2006
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