Weight loss is difficult for most people, but for new moms it can be an especially daunting task. The demands of motherhood, the time constraints and the general care of a newborn all tend to preempt activities that yield a healthy weight.
Calorie Control
There is no quick and easy all-star Hollywood crash diet or magic tea, powder, juice or pill that will melt the weight off. Whether you are pregnant or not, weight control is a simple game of numbers. If you eat more calories than you burn, the extra energy in those calories will be processed and deposited in the fat tissue. If you eat fewer calories than you require, the stored energy in the fat cells will be broken down so that it may be used to power the energy requirements of your body.
Managing Weight Before Pregnancy
The most sensible way to manage weight after pregnancy is to monitor and control weight gain during the course of pregnancy. The American Congress of Obstetricians and Gynecologists (ACOG) recommends the following guidelines: Underweight patients with a BMI (Body Mass Index) less than 18.5 are advised to gain 28 to 40 lb. Normal-weight patients with a BMI of 18.5 to 24.9 should target 25 to 35 lb. Overweight patients with a BMI of 25 to 29.9 should ideally gain 15 to 25 lb., and obese patients with a BMI of 30 or more should attempt to gain 11 to 20 lb. during the pregnancy. During the course of pregnancy the additional requirement in energy is only about 300 calories a day, so the meal that "baby" needs is roughly equivalent to a glass of milk and half a turkey sandwich.
Losing Weight After Pregnancy
After the birth, it is exceedingly important to lose the weight and achieve a normal BMI prior to the next pregnancy. Pooling data from the Pregnancy Nutrition Surveillance System (PNSS) between 2004 and 2006 showed that at six months post birth the average retention was 11.8 lb. What was more surprising was that 50 percent of patients retained more than 10 lb. and that 25 percent of women retained more than 20 lb. The added weight is concerning not only for cosmetic reasons but also because the retained weight increases the risk of infertility, gestational diabetes, preeclampsia, post-term pregnancy, wound infections, postpartum bleeding, stillbirth, large birth weight and elective or emergency C-sections.
Losing weight in the postpartum period has presented a problem for patients and also for providers. The recommendation by ACOG is that women should resume their regular activity postpartum as "medically advised." The issue is that 89.1 percent of patients do not receive exercise advice, and even when patients receive counseling this may not be enough to help them actually lose weight. The key to active post-pregnancy weight loss seems to be the participation of patients in structured diet and exercise routines, as demonstrated by a December 2003 study in the "Journal of Women's Health." This study randomly assigned patients to two groups. One group received individual diet and exercise regimens and met weekly during the first three months of the year-long study. They were also required to keep a food and activity diary. The other group received a single 1-hour counseling session. The average weight loss in the support group was 16.1 lb., with a 6 percent decrease in body fat, while the self-directed group experienced no significant change in either weight or body fat.
In addition to a support group and a structured diet and exercise program, some common areas have been identified as barriers and enablers to physical activity post partum. A January 1, 2010, article in the "Journal of Women's Health" identified scheduling, not enough time and lack of childcare as major barriers to physical activity and the desire to feel better about self and partner support as facilitators of physical activity.
Strategies for Weight Loss
A review of current trends and literature supports a multifaceted approach to weight loss. Joining a local support group that advocates meeting with other women with similar interests, along with investing in a dietary nutrition and personal trainer consultation, can help patients set reasonable and healthy goals. Because a "healthy" weight loss can be influenced by different factors for each patient, it is important to discuss this program with your physician. In order to maximize success patients must also overcome barriers and use enablers to their advantage. New moms have understandable demands on their attention and time, but they must remember that in order to take care of their family they must also take care of themselves. Utilizing family and partners to increase "me-time" can have many benefits. When relatives take care of the baby, perhaps a hike or walk can replace a big dinner and a movie. The benefits of joining support groups can also be exploited, and while daddy has his valuable bonding time with baby, mommy can cultivate healthy relationships with other moms and share in the joys of weight loss as a group.
The path to weight loss is tough but rewarding. When you achieve your goals don't forget to treat yourself to something special and cultivate a feeling of well-being and joy in life.
References
- ACOG: Guidelines for Weight Gain in Pregnancy
- Institute of Medicine; Weight Gain During Pregnancy: Reexamining the Guidelines; 2009
- "American Journal Obstetrics Gynecology"; Obesity, Obstetric Complications and Cesarean Delivery Rate --- A Population Based Screening Study; Weiss JL, et al.; 2004
- ACOG Committee Opinion no. 267: Exercise During Pregnancy and the Postpartum Period; 2002
- "Journal of Women's Health"; Provider Advice About Weight Loss and Physical Activity in the Postpartum Period; Renée M. Ferrari, et al.; March 2010
- "Journal of Women's Health"; Structured Diet and Physical Activity Prevent Postpartum Weight Retention; Mary L. O'Toole, et al.; December 2003
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