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Friday, October 19, 2012

Counseling Obese Moms-To-Be

9:15 AM Posted by Tiffany Taft , ,
A new Belgian study published in the International Journal of Obesity  found that "motivational counseling" helped reduce the amount of weight gained in obese moms-to-be from an average of 30lbs in those getting standard care to 23lbs in those participating in the treatment.  Not only did the counseling, which occurred in a group format, keep moms-to-be from gaining excessive amounts of weight, but it also helped reduce feelings of anxiety and depression.

I should emphasize that this study was for moms-to-be who were already obese prior to getting pregnant, as the recommended weight gain during pregnancy for an average weight woman is between 25 and 30 lbs.  As a relatively new first time mom, I learned a few things about pregnancy and the downright contradictory social expectations that pregnant women often encounter.  I won't get into them all here but I want to highlight a few.

"Go ahead, you're eating for 2 now!" ...."My God, you're HUGE!  Are you having twins?"

Pregnant women historically have been given carte blanche to eat what they want during pregnancy, and as much of it as they want.  You know, containers of ice cream with a side of pickles.  My thing was cheeseburgers (there went my decade of vegetarianism in one fell swoop!). We now know that gaining over 30lbs during pregnancy in a healthy weight woman can increase the risks for a variety of pregnancy complications, including gestational diabetes.  But you hear it all the time - eat!  Then if you do and put on too much weight, you begin receiving comments about how many babies exactly are residing in your belly.  Think about what these conflicting messages can do to a woman's psyche.  You're not eating enough, feed your baby!  Whoa, slow down heifer!  Nobody told you to eat that much!  We know that people who struggle with their weight often report "emotional eating" habits, so how are we helping women who may already be struggling with keeping their pregnancy weight down with these messages?

The Perfect Baby Bump

You've seen it on the covers of magazines in the grocery store checkout line.  Look at [insert starlet's name here]'s perfect baby bump!  There are websites and magazine articles dedicated to how to make sure your pregnancy is as cute as possible.  The fact is, at least in my experience, pregnancy is hard for a lot of women.  You're fighting incessant nausea, swollen sinuses, swollen ankles, back pain, hip pain, heartburn, and sleep issues to name a few.  So the pressure to have the body of Gisele Bundchen with a perfectly round bump while pregnant may be laughable on the surface, but beneath is a pressure to remain attractive over the next 9 months.  Women who don't achieve this status may feel depressed and unattractive, which adds stress to their pregnancies and may set them up for post-partum depression.

When are you going to lose that baby weight?

Ok, so you've had your baby and you're adjusting to an entirely new way of living your life.  You're up every few hours to feed and soothe your baby.  Why haven't you been hitting the gym 2 hours a day to lose those 50lbs you put on?  I mean come on, it's been at least 2 months.  Just look at Jessica Simpson and the heat she caught for not only the weight she gained but how slowly she was losing it.  There were 109 headlines about her baby weight alone.  For women who don't have millions of dollars or access to personal trainers and nannies, these expectations are ridiculous.  Yet this attitude isn't reserved for Jessica and many women who already struggled with their weight are facing the same struggle plus 40 pounds.

This is just a snippet of the social stigma of obesity as it relates to pregnancy.  The good news is programs like that in the Belgian study, run by midwives not psychologists, can be readily accessible.  Medical providers should acknowledge that moms-to-be, especially those who are at the most risk of significant weight gain, can benefit from support and counseling which ultimately leads to healthier and happier moms and babies.