Are You Obese During Pregnancy? Here’s How to Stay Healthy

Congrats- you’re expecting! Perhaps you’ve tried for many months- or even years- and it’s finally happened. Then again, maybe you really weren’t even trying.

Either way, you have a bouncing baby on the way, and you want to do everything you can to ensure that your baby is healthy.

However, one thing you’re already struggling with is your weight- and you know you’re only going to gain more.

Did you know that obesity during your pregnancy not only has a major impact on your own health- but the health of your baby as well?

Here, we will discuss some of the potential complications that can result, recommendations for healthy weight gain, and some things you can do to ensure a healthy pregnancy.

What exactly is considered obese?

Obesity is defined as an excess amount of body fat. The body mass index, or BMI, is a formula based on height and weight.

BMI is typically used to determine whether or not an individual is overweight or obese. Following is some BMI information:

If your BMI is below 18.5, you are considered underweight. A BMI of between 18.5 and 24.9 is considered normal/average weight.

If your BMI is between 25 and 29.9, you are considered to be overweight. If your BMI is 30 or higher, you are considered to be obese, and if your BMI is 40 or higher, you are considered to be extremely obese.

Your BMI number is calculated by the following formula: weight in pounds divided by height in inches squared multiplied by 703.

What are some causes and risk factors for becoming obese?

Generally, obesity is the result of a combination of causes and risk factors, including the following:

Genetics: the truth is that genes affect the amount of fat your body stores and where it distributes that fat. In addition, genetics influence how and the efficiency with which your body converts food into energy, as well as how your body burns calories when exercising.

Family lifestyle: Obesity runs in families—if one (or both) of your parents were/are obese, your chances of being obese are much higher. This isn’t just due to genetic factors but also because families tend to share both activity and eating habits.

Inactivity: You probably already know this, but if you’re not physically active, you’re not going to burn as many calories as someone who is.

When you live a sedentary lifestyle, you consume more calories each day than you burn, which can lead to obesity.

In addition, medical issues such as arthritis lead to decreased activity, leading to increased weight gain.

Unhealthy diet: When you make poor choices regarding what you’re eating—choosing foods that are high in calories as opposed to healthy foods such as fruits and veggies—you are more likely to gain weight and become obese.

Medical issues: in some cases, obesity is due to a medical issue such as Cushing’s syndrome, Prader-Willi syndrome, or other possible conditions.

As mentioned earlier, arthritis can also cause weight gain due to decreased physical activity levels.

Specific medications: there are some medications that can cause weight gain and lead to obesity if you’re not paying attention and compensating by consuming a healthy diet or getting adequate exercise.

These medications include the following: medications for controlling diabetes, antidepressants, antipsychotics, anti-seizure medications, beta-blockers, and steroids.

Social/economic issues: Some research supports the idea that social and/or economic factors influence obesity.

After all, it is very difficult to avoid becoming obese if you don’t have a safe area where you can exercise.

Also, if you haven’t been taught how to cook healthy meals or you don’t have the money to purchase healthy foods, you’re more likely to become obese.

Finally, if you’re spending time with unhealthy or obese friends and/or relatives, you’re more likely to gain weight.

Age: while it’s true that you can become obese at any age- even children can be obese- your chances of becoming obese do increase with age. After all, your body goes through many hormonal changes, which can sometimes lead to lower activity levels.

Since you’re not as active, you have less muscle mass, so your metabolism decreases. If you’re not active, your body doesn’t need as many calories- so if you don’t change your eating habits, you may find that you have a harder time keeping off extra weight.

You must consciously try to become more active (or maintain your activity levels) and pay more attention to what you’re eating.

Pregnancy: It is true that when you become pregnant, you will gain weight—that’s a given. However, many women find that since they’re “eating for two,” they eat more, which leads to more weight gain. Then, after they have the baby, they have difficulty losing weight.

Quitting smoking: smoking is a terrible habit- and sometimes, when an individual quits smoking, they gain weight.

In some cases, this weight gain leads to the condition of obesity. However, even though your risk of becoming obese is increased if you quit smoking, it is still better for you to quit than to keep smoking.

Lack of sleep/poor quality of sleep: If you’re not getting adequate sleep or too much sleep, you will notice changes in the hormones that control your appetite.

You will have an increased appetite and cravings for foods that are high in carbohydrates and calories. This can lead to weight gain, which can eventually lead to obesity.

Of course, even if you have one or more of the above risk factors, it doesn’t automatically mean you will become obese. You can make a concerted effort to get adequate exercise, pay close attention to your eating/make healthy dietary choices, and even change your behavior.

Is it possible for obesity to affect an individual’s ability to become pregnant?

Yes, when a woman is obese, her body may be unable to ovulate normally. In addition, obesity can have a significant impact on IVF or in-vitro fertilization. As a woman’s body mass index increases, so does the risk of being unable to conceive- through IVF or otherwise.

What are some of the effects of obesity on pregnancy?

Obesity during pregnancy- whether you were obese before you became pregnant or become obese as your pregnancy progresses- can increase the risk of the following complications:

Gestational diabetes: Women who have a normal weight are at a lower risk for developing a condition known as gestational diabetes. However, if you are obese while you are pregnant, you are much more likely to develop this condition. In some cases, diabetes will clear up after you give birth. On the other hand, the condition may continue- and you may pass it on to your baby.

Preeclampsia: obese women who are pregnant are at a much greater risk for developing a condition known as preeclampsia. This condition is characterized by high blood pressure and signs of damaged kidneys or other vital organ systems.

Infections: women who are obese while they are pregnant are at a much greater risk for developing urinary tract infections or UTIs. In addition, obesity while pregnant will increase your risk of developing a postpartum infection- whether you have a C-section or give birth vaginally.

Overdue pregnancy: women who are obese are at a much greater risk of carrying their baby beyond their expected due date. Women of normal weight are much more likely to deliver on time- or even just a little early.

Problems during labor: women who are obese while pregnant are at a much greater risk of having to be induced than women who are of normal weight. In addition, obesity can have an effect on pain medication- keeping it from working properly.

C-Section: if you are obese, you are much more likely to be required to have an emergency or elective C-section.

In addition, obesity will increase your risk of developing complications such as infections after having a C-section. Women who are obese before or during their pregnancy are much less likely to be able to have a successful VBAC or vaginal delivery after C-section.

Loss of pregnancy: women who are obese while pregnant are at a much greater risk of experiencing a stillbirth or miscarriage.

Can obesity have an effect on the baby?

In addition to an obese mom during pregnancy, you can cause some significant health issues for your baby, including the following:

Macrosomia: moms who are obese while pregnant are at a much greater risk of having a baby who is much larger than average, known as macrosomia.

These babies tend to have more body fat than other babies. The research does show that the higher the birth weight of a baby, the higher the risk of developing childhood obesity.

Chronic conditions: if you are obese while you are pregnant, your baby is at an increased risk of developing chronic health conditions such as diabetes or heart disease when they become adults.

Birth defects: some research has suggested that being obese while pregnant can increase the risk of giving birth to a baby with birth defects.

How much weight is healthy to gain during pregnancy?

When you are trying to determine a healthy weight to gain while pregnant, you should be aware that your pre-pregnancy BMI and weight, as well as your health and the health of your baby, will determine the amount of weight that is healthy for you to gain during your pregnancy.

You’ll want to talk with your physician or midwife to figure out what is best for you and to keep tabs on your weight gain throughout your pregnancy.

Of course, you can use some of the following general guidelines for weight gain during pregnancy and obesity:

• Single pregnancy: if you are already obese and you’re pregnant with one baby, it is recommended that you gain 11 to 20 pounds.
• Multiple pregnancies: if you are already obese and you’re carrying multiples, it is recommended that you gain 25 to 42 pounds.

Keep in mind that some research maintains that women who are already obese before becoming pregnant can safely gain less weight than the general guidelines suggest.

Instead of trying to gain or lose a specific amount of weight during your pregnancy, your physician or midwife may just encourage you to avoid gaining too much weight during your pregnancy.

Am I going to need any specialized care while I am pregnant?

If you’re already obese, your physician or midwife will be very closely monitoring your pregnancy. Of course, depending on your personal circumstances, your healthcare team will be likely to recommend one or more of the following:

Gestational diabetes testing: Typically, for women who are at average or an increased risk of developing gestational diabetes, a screening test known as the glucose challenge test is performed sometime between 24 and 28 weeks.

If you’re already obese, chances are that your physician or midwife will suggest that this test be done much earlier- even as early as your very first prenatal visit.

Even if the test comes back normal at this time, it will likely be done again between 24 and 28 weeks. On the other hand, if the results come back abnormal, you will be given further testing. Then, your physician or midwife will explain to you how to monitor and control your blood sugar levels.

Delayed ultrasound: A fetal ultrasound is typically performed between 18 and 20 weeks to evaluate the baby’s development and growth.

However, in obese moms, this will be delayed because the ultrasound waves do not penetrate abdominal fat very easily and, therefore, can cause some issues with the ultrasound. If the ultrasound is done later, between 20 to 22 weeks, it is much more likely to be detailed.

Fetal echocardiography: if you are obese while pregnant, your physician or midwife will likely suggest that a fetal echocardiogram be performed between 22 and 24 weeks.

This will give a detailed picture of your baby’s heart. The results of this will tell you whether or not your baby has a congenital heart defect.

Frequent prenatal visits: as you progress into your pregnancy, if you are obese, your physician or midwife is much more likely to recommend that you have prenatal visits more frequently than a mom who is of normal weight.

These will closely monitor both your health and the health of your baby. In addition, frequent fetal ultrasounds will likely be recommended to keep a close eye on your baby’s growth and development and to build a plan for your delivery.

What can be done to ensure that an obese mom has a healthy pregnancy?

While it’s true that obesity before or during pregnancy can impact your ability to have a healthy pregnancy, there are some things you can do to increase your health as well as the health of your baby. These steps include:

Have a preconception appointment: if you are considering becoming pregnant and you are already obese, you should definitely discuss your plans with your physician.

It may be recommended that you take a prenatal vitamin to become healthier or even visit other physicians, such as an obesity specialist or a registered dietician, who can help you get to a healthy weight before you become pregnant.

Ensure regular prenatal care visits: Regularly scheduled prenatal visits will help your physician monitor your health and the health of your developing baby.

You should speak with your physician about any medical conditions present, such as high blood pressure, sleep apnea, or diabetes, and find out some ways that you can manage them while pregnant.

Consume a healthy diet: you should speak with your physician or even a registered dietician to ensure that you are consuming a healthy diet and not gaining too much weight.

Remember that you will need more iron, calcium, folic acid, and other critical nutrients when you are pregnant.

A daily prenatal vitamin will fill in any gaps in your diet. You should speak with your physician if you have special nutritional needs due to a specific health condition.

Maintain/Become physically active: you should speak with your physician or midwife about an exercise program that is safe for you to continue or begin during your pregnancy.

Avoid risky substances: there are some things that you should avoid while pregnant, such as smoking, alcohol, and illicit drugs. If you have questions about specific medications or supplements that you’ve been taking, you should speak with your physician about them.

When you are obese before you become pregnant or become obese while you are pregnant, you will increase your risk of developing health complications for both you and your baby.

In order to ease your fears, you should discuss this with your physician or midwife. They will be able to keep you from gaining too much weight, properly manage your medical conditions, and keep an eye on your baby to ensure proper growth and development.

Sources:

http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-and-obesity/art-20044409

http://www.marchofdimes.org/pregnancy/being-overweight-during-pregnancy.aspx

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2621047/