Maybe I'm being a stickler, but I think it's important to reiterate that the 0-3% weight gain guideline applies to study participants, and that the study in question has not been completed yet. There are no findings. There is just a hypothesis based on "some data from observational studies" that suggests obese women still have healthy babies if they gain little to no weight during pregnancy, and study parameters designed to test that hypothesis. I understand having an opinion about the hypothesis, and/or the researchers' hopes and beliefs about what the study will reveal. But some of the comments here appear to be premised on the notion that the study produced findings supporting the hypothesis when in fact nothing has been proved or disproved yet. We don't yet know whether there is a statistically significant scientific relationship between zero weight gain for obese pregnant women, and healthy (or unhealthy as the case may be) pregnancies/babies for those same women. Indeed, the Kaiser press release about the study (dated October 21, 2009, and linked to in the NYT article) states that preliminary results from the study won't be available for three years.
I can't speak to weight but it does seem like it benefits a mom to at least be in decent cardiovascular shape for labor. I was watching that MTV show about the teen moms and that overweight girl (the one who the Soup made fun of for pigging out at Steak & Shake) clearly seemed to be struggling on the delivery table. It seems like labor is a marathon--screw it, like 6 marathons, if you were my mom--and you'd want to be prepared for that.
@Zulkey: Well, maybe. I handled labor well according to the doctor. I had a vaginal birth, no complications, no anesthesia, and pushed the baby out in under ten minutes. But, a lot of that comes down to luck and circumstance, not just fitness. My labor had been induced and judging by the constant contractions, my uterus was working very efficiently to push the baby out. But any woman could have complications that are unrelated to her fitness or general health: a stalled labor, a baby in the wrong position, problems with the umbilical cord. So while being prepared is great, birth is a process that women have limited control over.
@murasaki: well, yes, of course, I didn't mean to imply that if you're in good shape you're guaranteed a happy birth but it just seems to be common sense, maybe I'm wrong, that birthing is strenuous exercise and endurance can only help you.
A. Being allowed to eat whatever I want without getting judged about it is like, 90% of the reason I think pregnancy sounds awesome. (8% of the remainder is not having a period for nine months and 2% is eventually having a baby.)
2. I suspect the (probably) arbitrarily chosen number 170 for an obese amount to weigh is going to really bum out a lot of people.
I can sort of see this point, but who defines obese? If it's BMI, I'm laughing at you, scientists.
But, what do I know? I plan to (with help from my doctor) stay on meds for my anxiety during pregnancy. Or not have babies. Obviously, I already hate any future hypothetical child.
A lot depends on how docs dispense this info:"OK Porky, I don't see how you got laid, but since you did, here's what you do to avoid making your baby fat and stupid..."
I'd say pay more attention to what you eat, and you/your baby will be fine, regardless of what the scale says. But I try to tell myself that even without a zygote attached to my pipes.
And this may not mean anything, but my mom lost 16 pounds in the first half of her pregnancy with me, and had to go to into the hospital. I think she both couldn't eat anything and was a little scared to, which she admits was misguided because for a little bit she was afraid she might lose me.
Gosh, is there no end to all the shit women will do to kill their babies??? We're a bunch of lazy Big Mac eating baby-hating hogs who need teachable moments.
I am not a size hater. BUT, if a woman's DOCTOR suggests that she as an individual would benefit from participation in this study or losing weight, it should not automatically be dismissed as sizism.
There are several kinds of fat on a woman's body. Hip fat, which has high levels of DHA (crucial for brain development) typically accumulates during puberty and pregnancy. Abdominal fat has no such benefits- and it typically accumulates on nonpregnant people. Some obese women could lose weight by changing to an exceptionally healthy diet during pregnancy, causing them to lose abdominal fat- but since they gain hip fat and the weight of the baby itself, it is a net zero.
This is a judgement between an individual woman and her OB-GYN. But the concept of pregnancy as a teachable moment is not a bad one; I used to work in a maternity rehab center, and women who do have unhealthy habits can be greatly motivated to change. Interestingly, diet was a big thing with patients, too- they usually subsisted on junk food, alcohol, and cigarettes prior to pregnancy (which is just about as bad as the actual crack cocaine for fetal health- I am aware of the myriad social factors that drove them to drug addiction and I am not comparing obesity to drug addiction).
@SocialAnimal: "Some obese women could lose weight by changing to an exceptionally healthy diet during pregnancy"
Why are we assuming that obese women aren't ALREADY eating a healthy diet? Because they're "obese", whatever the hell that means? Because if this is about healthful eating, weight is a red herring.
I would take this much more seriously if it were about calcium and iron and fatty acids. Instead it seems to be about the fatties who insist on not only killing themselves, but their unborn babies too OMGTHINKOFTHEBABIES!!!!!!
@SocialAnimal: if a woman's DOCTOR suggests that she as an individual would benefit from participation in this study or losing weight, it should not automatically be dismissed as sizism
Thank you for this. In an age when heart disease is the #1 killer of women it should be possible for us to discuss the mal effects of obesity without being perceived as "sizist".
@Birthday Girl: I think there might be an idealized idea about the exchanges between an obsese woman and her doctor being presented here. Talking about weight gain with a standard doctor sucks. Hard. It's shameful and so wrapped up in emotion and self image, it's impossible to distance yourself and think logically about it. Frankly, I don't feel they care what I'm eating or how often I'm exercising, it's all about that one number. From what I've heard, my experiences are hardly unique. It's often noted that most doctors get very little training in nutrition and as Anna quoted above:
"the health care providers pregnant women visit most often aren't necessarily trained to recognize and address body image issues and eating disorders - but they are trained to track expectant mothers' weight and instruct them to keep it within a certain range. For women who struggle with disordered eating and body dissatisfaction, that can be problematic."
Most doctors aren't equipped to walk into the land mine that weight issues have become. So, I don't think a woman's DOCTOR's opinion is the end all, be all of her health. And I don't think that will change until we change as a culture. Both in the way we interact with food and in the way we treat the obese/overweight.
This is a much larger issue than just keeping chips and burgers away from the fatty, fatty fats fats. It's about re-evaluating our lifestyles and maybe our ideas of "health".
@schlegs84: No, the opinion of a DOCTOR should be offered to a woman as a respected, knowledgeable individual giving her advice. If my mechanic tells me I should change the battery in my car, I will weigh my options, but I'll give his/her opinion greater credence.
Of course, doctors can be insensitive. But the doctor is the one person qualified to know if the individual pregnant woman is obese due to poor eating habits that could be changed (no one else should assume so). Mental illness, alcohol consumption, obesity- all of these things can be extremely detrimental to a person's well-being in some circumstances, and a doctor is in a position to offer the best advice on whether those circumstances exist in this case.
@RedSonja-tamer-of-wild-animals: Ahem.
"SOME" negates an assumption that obese women aren't already eating a healthy diet. That's why I wrote that. Some obese women are obese due to medication, physical issues limiting activity, or other reasons. Some are obese because they eat a lot of high-calorie, low-nutrient food.
And actually, when you're pregnant, you do have to THINKOFTHEBABIES!!!. Gestational diabetes is not a good thing for a developing fetus. If a woman is at extra risk for developing gestational diabetes due to her obesity, it is not at all unreasonable for a doctor to suggest she alter her eating habits.
I like to drink beer- not an unhealthy level, but I greatly enjoy craft beer. Were I pregnant tomorrow, my doctor would irresponsible not to suggest that I curtail my beer drinking. Some studies say alcohol consumption will not affect my long-term health, some say it might. She would suggest that I make my behaviors as healthy as possible, and the ultimate decision would be mine to make.
@SocialAnimal: I agree with you. I feel that sometimes Jezebel and it's readers need to step down off their podiums of indignation towards sizism and accept the fact that obesity is a dangerous problem and it is also unhealthy for the mother in question and her fetus.
@SocialAnimal: I see what you're trying to say and I wish the world worked that way. Do you see how the analogy of a car battery doesn't carry the same emotional implications that a woman's body does?
I think you're giving doctors a bit too much credit in knowing a patient's day to day habits. While I certainly agree that a woman's doctor should be in best position to offer her advice, I think they often know much less than they should about an individual's actual diet/activity level b/c the focus is always on the number on the scale.
My main points is that these patient/doctor relationships and obesity are a symptom of our unhealthy culture. The disease needs to be fixed, not the symptoms.
I'm coming at this story from the perspective of a scientist. I'm not trying to upset anyone. This study isn't trying to shame anyone for being obese or trying to shame anyone into losing weight.
The results of the study indicate that in the case of women defined as "obese," it is most advantageous for the fetus for the mother to gain as little weight as possible. I'm not certain what the end points were that the study measured, but I don't think that the study is advocating weight loss for pregnant women.
@Dorilys: The thing is, ANY pregnant woman will gain weight while pregnant by virtue of the added weight of the fetus, the increased blood volume, placenta, etc. In order to create a zero weight gain during pregnancy, women actually would have to lose some of their "maternal stores" (aka fat) so that the aforesaid necessary gain is zeroed out.
@weese17: The study didn't say 0% weight gain, it said 0-3%.
In addition, the study hasn't even occurred yet, so we don't know that zero weight gain is actually ideal.
They haven't actually proposed a new guideline, from what I understand about the actual study, as they are still trying to enroll people. And, it seems like they're looking at what is best for the fetus rather than what is feasible and/or best for the mother.
@weese17: Really? I interpreted it to mean that the mother's weight when she becomes pregnant would be the same as after giving birth. So their may be some weight gain from baby+placenta+fluids, but within maybe a week after the birth, the mother shouldn't be 20 lbs heavier than she was when she got pregnant.
@Dorilys: You said what I've been wanting to say reading these comments.
It is not a guideline. They are not making a 'law'. And even if your doctor decides that they like this study, you can choose to find a new doctor or just do what you think is best no matter what some study says. Simple as that. People choose to switch doctors all the time for things other than pregnancy, and it is an annoyance of course, but it is an option.
Wait, wait. I'm planning on getting pregnant next year. I have to give up soft cheese?? Goddamn desire to procreate, you take all the fun out of everything!
@Ipomoea: I didn't, if that helps you. I figured, never had listeriosis before, not likely to get it just because I was pregnant. But if you stay with domestic cheeses, all of which have to be pasteurized, you ought to be fine.
@Ipomoea: Depends on your ob-gyn. Mine told me pasteurized soft cheese was fine, but other docs have said no soft cheese at all. I think the issue is really the pasteurization.
@Ipomoea: I'm sure that you won't really have to. I'm not sure of the exact history of the "no soft cheese" recommendation but I would bet a pretty penny that they never said that before the 1970's (when most of the stricter prohibitions came into play) and, as you can see, most people born before 1970 are completely normal human beings.
@Ipomoea: I gave it up at first because I had a OB that scared the crap out of me with the risks of everything from baths to soft cheese. When I switched to a Dr. I liked I was shocked to find out just how much of pregnancy info is scare tactics. Safe to say with this second pregnancy pass the brie!
@TheFormerJuneBronson: I think pregnant women are for some reason more at risk to contract listeriosis, so that's why the advisory to avoid soft cheese, cold cuts, hot dogs, etc. exists.
Though yes, it's still rare to come across food that's actually infected with listeria.
@Birthday Girl: Before the last few decades, doctors didn't tell pregnant women not to smoke or drink, because no one saw it as a fetal health risk. The majority of people born in, say, the 50s and 60s are fine, but that doesn't mean that the risk isn't there. Doctors should warn pregnant women what's potentially dangerous, even if the actual risk is relatively small, because someone down the line is going to contract listeriosis from soft cheese or cold cuts.
@everyone: Yeah, I know the soft cheese thing is a minor possibility, but I know there's so much food/stuff that I love that I'll have to give up when I'm pregnant (sashimi, coffee, Diet Coke, champagne, etc), that it's dismaying. I gather that it's worth it in the end, however.
@onestrawplz: Yeah, the concern is that pregnant women are at risk (though their illness is generally mild), and it can cause premature birth or meningitis in the fetus. But you're right that it's not terribly common.
Pooh. I am not paying any attention. I was in the "overweight" category before I got pregnant. I have now gained 35 pounds and expect another 25 (from experience) in water in the next two months before I pop.
I only eat when I am hungry, and I generally eat good stuff.
@redqueenmeg: My feeling also. I gained 30 when pregnant, and lost 25 of it before I even left the hospital. I had no appetite for the first six months and after that, my stomach was too squished to each much. I don't see how anyone eating normally could avoid gaining some weight during pregnancy. You aren't turning your own body fat into the baby. You're retaining water for amniotic fluid and you're growing a baby, for crying out loud. No matter what the scientific basis, this strikes me as alarmist and unrealistic.
@TheFormerJuneBronson: Heh, 30 total would be so cool to me though! I gained 80 with the last one and expect to do so again. Then again I have huge children so oh well. But yes, QUITE alarmist and unrealistic.
I'm just tired of being off everyone's charts and--while able to fit my *BELLY* into maternity clothes, unable to fit my *BREASTS* into them because even when I am pregnant my body is *STILL WRONG*, thank you soooo much clothing designers!
@morninggloria: I grew my fetus under my couch by the radiator vents to keep it warm. Right next to that issue of TV guide I can't bring myself to throw away - the one about the final episode of Seinfeld - and the remote for my betamax player.
My fetus probably has a dust allergy by now. I am a bad mother.
My co-worker is the only person I've ever met who lost weight during pregnancy. Between start to finish, 25 pounds came off. She was definitely overweight at the beginning (what she referred to as "law school butt).
However, she also found out she was pregnant 5 1/2 months into her pregnancy, as she needed major abdominal surgery to correct a previous, screwed-up bladder surgery. The net result was that she was puking and bleeding out of every which end for several months, and it took a while for her to separate feeling horrible from feeling pregnant. She lost most of the weight from after-effects of the surgery.
Her daughter was a tremendous shock, but also very much wanted. She turned out just fine. Her mom had a rough time of it, between the weight loss and the pregnancy.
Not exactly a ringing endorsement for losing weight while pregnant.
I'd also like to point out that a baby weighs anywhere from 7-10 lbs., the placenta 1-2, extra blood and fluid is at least 5 lbs., and the uterus gains muscle -- for a total of around 20-25 lbs. So they're asking women to LOSE 25 lbs., something I can't even do in 30 weeks (and I'm not pregnant). Awesome.
@spamanda: Thank you for pointing out the real numbers at play here. An average pregnancy causes much more (healthy, normal) weight gain than just the weight of the baby. Many women also retain lots of water weight (you should have seen the size of my ankles!). This study is completely and utterly fucked up.
@mrs_weasley: I had amazing cankles when I was pregnant with my first. I probably gained 10 lbs. in water at the end of my pregnancy. And peed it all out in a matter of days. Yes, this study is ridiculous.
Oh goody, can we use BMI to decide which women are overweight? Because we all know how accurate THAT is!
Ugh, I'm so upset by this article I can hardly think straight. Way to fat-shame pregnant women. How about we educate people (men and women) to eat healthy? Sure pregnancy is a good time to start healthier habits (quit smoking, etc) but maybe pregnant women have ENOUGH to worry about, without stressing over the exact number of pounds they gained and how "fat" they are.
@spamanda: I heard that pregnancy sizes were different in the '50s too. Fetuses also came in mini-size, so women weren't gaining all those icky life-sustaining pounds.
@spamanda: I think we should strive to have thin babies, like weighing 7 lbs or under, any baby who weighs more than that is a fatty and should be shamed accordingly.
@Kitten is an 80s rocker: I have friends who had children in the 50s and 60s, and they were not "allowed" to gain more than 15 lbs. In fact, one of my friends said she basically stopped eating at the end of her pregnancy, because she was told if she gained "too much" they'd have to do a cesarean.
03:26 PM
03:17 PM
Yes. Because grown women capable of bringing life to the world are truly just lil' wimmins who need to be "taught" how to live correctly. Fuck. You.
02:29 PM
03:48 PM
04:00 PM
12:50 PM
2. I suspect the (probably) arbitrarily chosen number 170 for an obese amount to weigh is going to really bum out a lot of people.
12:20 PM
But, what do I know? I plan to (with help from my doctor) stay on meds for my anxiety during pregnancy. Or not have babies. Obviously, I already hate any future hypothetical child.
A lot depends on how docs dispense this info:"OK Porky, I don't see how you got laid, but since you did, here's what you do to avoid making your baby fat and stupid..."
I'd say pay more attention to what you eat, and you/your baby will be fine, regardless of what the scale says. But I try to tell myself that even without a zygote attached to my pipes.
And this may not mean anything, but my mom lost 16 pounds in the first half of her pregnancy with me, and had to go to into the hospital. I think she both couldn't eat anything and was a little scared to, which she admits was misguided because for a little bit she was afraid she might lose me.
10:52 AM
10:48 AM
There are several kinds of fat on a woman's body. Hip fat, which has high levels of DHA (crucial for brain development) typically accumulates during puberty and pregnancy. Abdominal fat has no such benefits- and it typically accumulates on nonpregnant people. Some obese women could lose weight by changing to an exceptionally healthy diet during pregnancy, causing them to lose abdominal fat- but since they gain hip fat and the weight of the baby itself, it is a net zero.
This is a judgement between an individual woman and her OB-GYN. But the concept of pregnancy as a teachable moment is not a bad one; I used to work in a maternity rehab center, and women who do have unhealthy habits can be greatly motivated to change. Interestingly, diet was a big thing with patients, too- they usually subsisted on junk food, alcohol, and cigarettes prior to pregnancy (which is just about as bad as the actual crack cocaine for fetal health- I am aware of the myriad social factors that drove them to drug addiction and I am not comparing obesity to drug addiction).
11:03 AM
Why are we assuming that obese women aren't ALREADY eating a healthy diet? Because they're "obese", whatever the hell that means? Because if this is about healthful eating, weight is a red herring.
I would take this much more seriously if it were about calcium and iron and fatty acids. Instead it seems to be about the fatties who insist on not only killing themselves, but their unborn babies too OMGTHINKOFTHEBABIES!!!!!!
11:05 AM
Thank you for this. In an age when heart disease is the #1 killer of women it should be possible for us to discuss the mal effects of obesity without being perceived as "sizist".
11:35 AM
"the health care providers pregnant women visit most often aren't necessarily trained to recognize and address body image issues and eating disorders - but they are trained to track expectant mothers' weight and instruct them to keep it within a certain range. For women who struggle with disordered eating and body dissatisfaction, that can be problematic."
Most doctors aren't equipped to walk into the land mine that weight issues have become. So, I don't think a woman's DOCTOR's opinion is the end all, be all of her health. And I don't think that will change until we change as a culture. Both in the way we interact with food and in the way we treat the obese/overweight.
This is a much larger issue than just keeping chips and burgers away from the fatty, fatty fats fats. It's about re-evaluating our lifestyles and maybe our ideas of "health".
12:33 PM
Of course, doctors can be insensitive. But the doctor is the one person qualified to know if the individual pregnant woman is obese due to poor eating habits that could be changed (no one else should assume so). Mental illness, alcohol consumption, obesity- all of these things can be extremely detrimental to a person's well-being in some circumstances, and a doctor is in a position to offer the best advice on whether those circumstances exist in this case.
12:42 PM
"SOME" negates an assumption that obese women aren't already eating a healthy diet. That's why I wrote that. Some obese women are obese due to medication, physical issues limiting activity, or other reasons. Some are obese because they eat a lot of high-calorie, low-nutrient food.
And actually, when you're pregnant, you do have to THINKOFTHEBABIES!!!. Gestational diabetes is not a good thing for a developing fetus. If a woman is at extra risk for developing gestational diabetes due to her obesity, it is not at all unreasonable for a doctor to suggest she alter her eating habits.
I like to drink beer- not an unhealthy level, but I greatly enjoy craft beer. Were I pregnant tomorrow, my doctor would irresponsible not to suggest that I curtail my beer drinking. Some studies say alcohol consumption will not affect my long-term health, some say it might. She would suggest that I make my behaviors as healthy as possible, and the ultimate decision would be mine to make.
01:01 PM
01:54 PM
02:00 PM
I think you're giving doctors a bit too much credit in knowing a patient's day to day habits. While I certainly agree that a woman's doctor should be in best position to offer her advice, I think they often know much less than they should about an individual's actual diet/activity level b/c the focus is always on the number on the scale.
My main points is that these patient/doctor relationships and obesity are a symptom of our unhealthy culture. The disease needs to be fixed, not the symptoms.
02:17 PM
03:12 PM
10:30 AM
10:52 AM
[www.americanpregnancy.org]
10:28 AM
The results of the study indicate that in the case of women defined as "obese," it is most advantageous for the fetus for the mother to gain as little weight as possible. I'm not certain what the end points were that the study measured, but I don't think that the study is advocating weight loss for pregnant women.
10:33 AM
10:44 AM
In addition, the study hasn't even occurred yet, so we don't know that zero weight gain is actually ideal.
They haven't actually proposed a new guideline, from what I understand about the actual study, as they are still trying to enroll people. And, it seems like they're looking at what is best for the fetus rather than what is feasible and/or best for the mother.
11:33 AM
11:41 AM
11:54 AM
It is not a guideline. They are not making a 'law'. And even if your doctor decides that they like this study, you can choose to find a new doctor or just do what you think is best no matter what some study says. Simple as that. People choose to switch doctors all the time for things other than pregnancy, and it is an annoyance of course, but it is an option.
10:17 AM
10:21 AM
10:33 AM
10:35 AM
10:49 AM
I'm more concerned about the lack of fake sugars (ie no diet pop). I love me some diet pop.
10:51 AM
10:58 AM
12:42 PM
Though yes, it's still rare to come across food that's actually infected with listeria.
12:47 PM
01:28 PM
01:30 PM
03:03 PM
09:59 AM
I only eat when I am hungry, and I generally eat good stuff.
So these people can totally bite me.
10:36 AM
12:15 PM
I'm just tired of being off everyone's charts and--while able to fit my *BELLY* into maternity clothes, unable to fit my *BREASTS* into them because even when I am pregnant my body is *STILL WRONG*, thank you soooo much clothing designers!
/rant off
09:59 AM
10:01 AM
My fetus probably has a dust allergy by now. I am a bad mother.
10:26 AM
09:43 AM
However, she also found out she was pregnant 5 1/2 months into her pregnancy, as she needed major abdominal surgery to correct a previous, screwed-up bladder surgery. The net result was that she was puking and bleeding out of every which end for several months, and it took a while for her to separate feeling horrible from feeling pregnant. She lost most of the weight from after-effects of the surgery.
Her daughter was a tremendous shock, but also very much wanted. She turned out just fine. Her mom had a rough time of it, between the weight loss and the pregnancy.
Not exactly a ringing endorsement for losing weight while pregnant.
09:43 AM
09:52 AM
10:13 AM
10:14 AM
10:14 AM
09:41 AM
Ugh, I'm so upset by this article I can hardly think straight. Way to fat-shame pregnant women. How about we educate people (men and women) to eat healthy? Sure pregnancy is a good time to start healthier habits (quit smoking, etc) but maybe pregnant women have ENOUGH to worry about, without stressing over the exact number of pounds they gained and how "fat" they are.
09:52 AM
09:54 AM
10:13 AM
10:27 AM