Obesity in Pregnancy

A really depressing article was published last week in the New England Journal of Medicine. The Harvard T.H. Chan School of Public Health published a study predicting that if current trends continue, 57% of today's kids will be obese by the time they reach age 35. That is a heartbreaking projection for our children. Obesity is associated with an increased risk of serious health conditions, like diabetes, hypertension, and cancer. The biggest predictor of adult obesity was not surprising- excess weight in childhood.

So how do we course-correct? How do we affect this disturbing trend? I'm glad you asked. Here are some of the best ways to safeguard the health of your children and yourself:

  • Take steps to improve your own weight. Ideally, prior to becoming pregnant. If you are overweight or obese when you become pregnant, your risks are higher for gestational diabetes, pregnancy-related hypertension, sleep apnea, birth defects, and higher birth weight babies. If you are obese and lose just 5-10% (15-20 pounds) of your body weight before getting pregnant, the outlook for your pregnancy is better.

  • If you are overweight or obese and already pregnant, don't panic. You can focus on limiting your weight gain in pregnancy. Not everyone needs to gain 20-30 pounds; some women may not need to gain at all. The best way to control your weight gain is to limit starchy carbohydrates and processed foods, and exercise at least 20-30 minutes daily.

  • Recent studies have shown that your nutrition and weight gain in pregnancy are powerful determinants of your child's risk of obesity. One study looked specifically at sugar-sweetened beverages (SSBs) in pregnancy. The researchers found that when women in their first and second trimesters drank SSBs, their children were significantly more likely to be obese by the time they started school. Even if the kids didn't drink these beverages. Even if they were active and ate well.

It is clear that the decisions you make during your pregnancy affect you, your baby, and the child that your baby will become. Remember this when you are tempted to overeat. The concept of "eating for two" is outdated and even dangerous. I am getting ready to publish a guide to managing gestational diabetes. The dietary guidelines are tailored for diabetes, but they apply to anyone who wants to manage their weight gain, stay active, and have energy to spare. Stay tuned.

No matter what your current weight is or how far along you are in your pregnancy, it's not too late to improve your health and your baby's. Begin where you are. Take a walk. Say goodbye to soft drinks. No effort is too small. And these small steps can add up to big changes. You've got this!

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