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Destination: Delivery / A Road Map Through Pregnancy
| Issue: Putting on Pounds

Weighty Matters

For many women, the padding doesn't go away after the baby arrives. Now obesity researchers are also focusing on that time of hormonal and eating-behavior change.


It's a common complaint voiced at gyms, in doctors' offices, at weight-loss centers--wherever women contemplate their weight.

"I was thin until I had my baby."

"I never lost my pregnancy weight."

"I gained more weight with each baby."

Americans' battle with obesity has long been recognized as a major health problem. Now, in an effort to better understand the problem, researchers are looking at weight gain over a woman's life cycle, with particular attention paid to pregnancy.

"We're all getting fatter, but at every point along the curve, women are fatter than men," says Jennifer Lovejoy, chief of the Women's Health Research Program at the Pennington Biomedical Research Center, Louisiana State University. From age 25 to 34, she notes, men have a 3.9% chance of gaining 22 pounds. For women the risk is double--about 8.4%.

Why the difference? There are no clear-cut answers. But researchers like Lovejoy, a physiological psychologist, are pointing a finger at pregnancy as one possible factor.

"I was doing metabolic studies on women, and I was hearing from about half of these women--who were middle-aged and obese--that they became obese after their first pregnancy," she says.

Until recently, few studies had been done on pregnancy weight gain and its effects on both maternal and infant health. But Lovejoy's research along with other newer studies could precipitate a shift in thinking on how a pregnant woman puts on weight.

Putting on Pounds for the Baby's Good

Long-term obesity in women has major health consequences, including an increased risk of heart disease, hypertension, diabetes and certain cancers. But the issue of pregnancy weight gain is touchy because the health of the mother must be balanced with the health of the baby. Given the nutritional needs of the growing fetus, pregnancy is no time to start a diet.

But the concept of eating for two has taken on mythic proportions.

"I think there are a lot of people, even physicians, who think, 'The more weight you gain, the better. Don't worry about it; you can lose it later.' But that is just not the case," Lovejoy says.

While researchers are still trying to figure out if the optimal weight gain for the mother is the optimal weight gain for the infant, there is some consensus that many pregnant women gain too much weight. Maternal obesity is defined in most studies as weight above 175 pounds or weight that is more than 50% beyond the ideal prepregnancy body weight.

Studies show that the average woman retains two to five pounds after having a baby. While adults tend to gain weight as they age, gaining two to five pounds over nine months is far beyond the normal pace related to aging.

And that's the average woman. Many other women end up 20 pounds or more heavier long after childbirth. About 10% to 15% of women are at risk for retaining more than 22 pounds. Minority women are especially susceptible. Black women are twice as likely to retain 20 pounds as white women.

Studies have also shown that the more babies a woman has, the more weight she is likely to retain, regardless of her age.

Tammy (who asked that her full name not be used) typifies women who find themselves blessed with a baby but left dissatisfied with their bodies.

The Los Angeles homemaker became pregnant at 37. Tammy had waged a long battle with her weight and felt she was still about 10 to 15 pounds over her optimal weight when she conceived.

"Prior to getting pregnant, I had lost a good deal of weight. I had been on an eating plan, according to a doctor; portioning my food to get down to a good weight to get pregnant at," she says.

Pregnancy put a quick end to dieting.

"Suddenly, to my psyche, being pregnant was a license to eat," Tammy says. "I didn't eat junk food but would feed myself whenever I was hungry. Then, when I was three months' pregnant my obstetrician turned to me and said, 'Now, dear, gaining 30 pounds during pregnancy is not a bad thing. But you've managed to do it in the first three months. This is the start of a bad trend.' "

Tammy quickly got her eating habits under control and gained only 15 pounds more during the last two trimesters. Her baby was born healthy and of average weight. But--five years later--Tammy is still struggling to lose 30 pounds she has retained from that pregnancy.

Many factors--including ethnicity, occupation and the interval between pregnancies--can contribute to weight retention after pregnancy. But Tammy's case illustrates a few key factors that are thought to cause too much weight gain, Lovejoy says. These include the timing of weight gain, energy expenditure, hormonal changes and eating behavior changes during pregnancy.

A 1996 study, for example, tracked women as they gained weight throughout a pregnancy and how much they retained. It found that a whopping 86% of the weight gained in the first trimester is retained by the mother, whereas pounds added in the third trimester didn't seem to stick to moms' hips after childbirth because they contributed more to infant weight.

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