How to Safely Lose Weight During Pregnancy

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Pregnancy is a beautiful and transformative journey, but it also brings with it a slew of physical changes, including weight gain.

While it’s normal and necessary to put on weight during pregnancy, excessive weight gain can increase the risk of health complications for both the mother and the baby.

That’s why it’s important to manage weight gain in a safe and effective way during pregnancy.

In this blog post, we’ll explore the best practices for managing weight during pregnancy, including healthy eating habits, exercise recommendations, and tips.

Weight loss before pregnancy

Losing weight and being at a healthier weight before pregnancy is important for obese women because it can significantly reduce the risk of various health complications during pregnancy and improve the overall health of both the mother and the baby.

Improved fertility

Obesity can have a negative impact on fertility in women, and losing weight can help to improve fertility by addressing some of the underlying causes. Here are some ways in which weight loss can improve fertility in obese women:

Hormonal balance: Obesity can disrupt hormonal balance in the body, leading to irregular menstrual cycles and ovulation problems. Losing weight can help to restore hormonal balance and improve fertility.
Reduced insulin resistance: Obese women are more likely to have insulin resistance, which can lead to high blood sugar levels and other metabolic problems. Losing weight can help to reduce insulin resistance and improve fertility.
Improved egg quality: Obesity can affect the quality of eggs produced by the ovaries, which can make it more difficult to conceive. Losing weight can help to improve egg quality and increase the chances of getting pregnant.
Reduced inflammation: Obesity can cause inflammation in the body, which can affect fertility by disrupting the normal functioning of the reproductive system. Losing weight can help to reduce inflammation and improve fertility.
Improved response to fertility treatments: Obese women may have a lower response to fertility treatments such as IVF, and losing weight can improve the chances of success with these treatments.

Reduced risks

Obesity during pregnancy can increase the risk of various health problems for both the mother and the baby. Some of the common risks associated with obesity during pregnancy include:

Gestational Diabetes: Obese pregnant women have a higher risk of developing gestational diabetes, a condition in which the body is unable to produce enough insulin to regulate blood sugar levels during pregnancy.
Hypertension: High blood pressure is a common complication of pregnancy, and obesity increases the risk of developing hypertension during pregnancy.
Pre-eclampsia: This is a severe form of hypertension that can develop in obese pregnant women, which can cause damage to organs such as the liver and kidneys, and can lead to premature delivery or stillbirth.
Delivery complications: Obese women are more likely to require a C-section delivery due to various factors such as the baby’s size or the mother’s inability to tolerate labor.
Preterm birth: Obese women have a higher risk of delivering prematurely, which can increase the risk of breathing problems, infections, and other complications for the baby.
Birth defects: Obesity during pregnancy has been associated with an increased risk of birth defects, including neural tube defects and heart defects.
Macrosomia: Obese women are more likely to give birth to larger babies, which can increase the risk of delivery complications and the need for a C-section.
Postpartum complications: Obese women are at higher risk of postpartum complications such as infections, bleeding, and blood clots.

Weight gain during pregnancy

You shouldn’t be looking to actively lose weight, nor is it recommended you partake in heavy dietary restrictions during pregnancy. Your nutritional intake during these times will affect the health of your developing baby, and your baby will need all the nutrition it can get.

Weight gain during pregnancy is expected and necessary for the health of both the mother and the developing fetus. The amount of weight gain recommended for women during pregnancy depends on their pre-pregnancy weight status, as follows:

Underweight women (BMI less than 18.5): It is recommended that underweight women gain between 28 and 40 pounds during pregnancy.
Normal weight women (BMI between 18.5 and 24.9): Normal weight women are recommended to gain between 25 and 35 pounds during pregnancy.
Overweight women (BMI between 25 and 29.9): Overweight women should aim to gain between 15 and 25 pounds during pregnancy.
Obese women (BMI greater than or equal to 30): Obese women are recommended to gain between 11 and 20 pounds during pregnancy.

It’s important to note that these are general guidelines and may vary depending on individual circumstances. Women who are carrying multiple fetuses, have certain medical conditions, or have a history of preterm birth may require different weight gain recommendations.

Focus on healthy eating

Just because you shouldn’t be overly worried about losing weight while pregnant, doesn’t mean you should eat whatever you want, whenever you want.

Rather than restriction of a particular macronutrient, the focus should be on a balanced and healthy diet. For example, for an overweight pregnant mother, I would recommend a more balanced Mediterranean style diet, rather than say the ketogenic diet.

Moderate calorie control

If you need to control your weight during pregnancy, the best strategy would be moderate calorie control, to avoid the macronutrient extremes of some other diets.

The number of calories recommended for pregnant women depends on their pre-pregnancy weight status and their level of physical activity. Here are the general calorie recommendations for pregnant women:

Underweight women (BMI less than 18.5): Underweight women are recommended to consume an additional 300 to 500 calories per day during the second and third trimesters of pregnancy, in addition to their pre-pregnancy calorie needs. This would typically be a total of 2,200 to 2,500 calories per day.
Normal weight women (BMI between 18.5 and 24.9): Normal weight women should consume an additional 300 calories per day during the second and third trimesters of pregnancy, on top of their pre-pregnancy calorie needs. This would typically be a total of 2,200 to 2,500 calories per day.
Overweight women (BMI between 25 and 29.9): Overweight women should aim to consume the same number of calories as they did before pregnancy during the first trimester. During the second and third trimesters, they should consume an additional 200 to 300 calories per day, for a total of 2,000 to 2,400 calories per day.
Obese women (BMI greater than or equal to 30): Obese women should aim to consume the same number of calories as they did before pregnancy during the first trimester. During the second and third trimesters, they should consume an additional 100 to 200 calories per day, for a total of 1,800 to 2,200 calories per day.

Stay active

Research has consistently shown that exercise during pregnancy is safe and beneficial for both the mother and the developing fetus. In fact, the American College of Obstetricians and Gynecologists (ACOG) recommends that pregnant women get at least 150 minutes of moderate-intensity aerobic activity per week.

Despite the overwhelming evidence that exercise is safe and beneficial during pregnancy, there are still some misconceptions and myths that persist, including the idea that any exercise can harm the fetus. This idea is unfounded and not supported by scientific research.

There are several other reasons why it is important for pregnant women to stay active and exercise:

Promotes healthy pregnancy: Regular physical activity can help promote a healthy pregnancy by reducing the risk of complications such as gestational diabetes, preeclampsia, and preterm delivery.
Boosts mood and energy: Exercise releases endorphins, which can improve mood and energy levels. This can be particularly important during pregnancy, when mood swings and fatigue are common.
Prepares for labor and delivery: Exercise can help prepare the body for labor and delivery by increasing stamina, improving muscle strength, and enhancing flexibility.
Reduces discomfort: Pregnancy can cause a range of discomforts such as back pain, constipation, and swelling. Exercise can help alleviate some of these discomforts and improve overall well-being.
Improves postpartum recovery: Staying active during pregnancy can also help with postpartum recovery by maintaining muscle tone and strength, which can help with the physical demands of caring for a newborn.

Here are some examples of good exercises for pregnant women:

Walking: Walking is a low-impact exercise that can be done at any time during pregnancy. It’s a great way to get some fresh air and stay active without putting too much strain on your body.
Swimming: Swimming is a great exercise for pregnant women because it’s gentle on the joints and can help reduce swelling. It can also be a good way to stay cool during the hot summer months.
Prenatal yoga: Prenatal yoga can help improve flexibility, reduce stress, and prepare the body for childbirth. Look for a prenatal yoga class specifically designed for pregnant women.
Low-impact aerobics: Low-impact aerobics classes, such as prenatal dance classes or step aerobics, can be a fun way to stay active during pregnancy while also improving cardiovascular health.
Pelvic floor exercises: Pelvic floor exercises, also known as Kegels, can help strengthen the muscles that support the bladder, uterus, and rectum, and can help prevent or reduce urinary incontinence.
Stationary cycling: Cycling on a stationary bike is a low-impact way to get your heart rate up and improve cardiovascular health during pregnancy. Adjust the resistance and speed to a comfortable level and avoid standing up while pedaling.
Resistance band exercises: Resistance band exercises can help strengthen muscles without putting too much strain on joints. Exercises like bicep curls, tricep extensions, and lateral raises can help maintain upper body strength during pregnancy.
Modified Pilates: Pilates can help improve posture, strengthen the core, and reduce back pain during pregnancy. Look for a prenatal Pilates class or modify traditional Pilates exercises as needed to make them safe for pregnancy.

Weight loss after pregnancy

Focus on losing weight after pregnancy. Studies show that the actual weight retained shortly after pregnancy is relatively small, around 1-5 pounds. Studies that look at weight gain 1-2 years after pregnancy show more significant gains in high risk mother’s, anywhere from 10-50 pounds.

This suggests that most of the weight gained and retained occur in the many months and years after pregnancy, not during pregnancy. Most of the weight gained during pregnancy is lost shortly after pregnancy.

My experience with weight loss patients really reflects this, as new mother’s often do not have the time or energy to focus on their diet, and by the time they do years later, their weight has already steadily risen.

Have a dietary plan ready after pregnancy, whether you decide to go low-carbohydrate, or whatever, know that you’ll have to start watching what you eat as soon as possible after giving birth, if you want to minimize weight gain down the road.

I suggest a more gradual weight loss protocol, with a goal to lose something like 1 pound a week.

Breastfeed more

Breastfeeding can help women lose weight after pregnancy in a few ways:

Burns calories: Breastfeeding burns calories. In fact, producing breast milk can burn up to 500 calories a day. This can help women to lose weight faster.
Hormonal changes: During breastfeeding, the hormone oxytocin is released, which can help to shrink the uterus back to its pre-pregnancy size. This can also help women to lose weight.
Appetite control: Breastfeeding can help to regulate a woman’s appetite by increasing levels of the hormone leptin, which signals the brain that the body has had enough to eat. This can help women to avoid overeating and manage their weight.
Improves metabolism: Breastfeeding can also improve a woman’s metabolism. The hormone prolactin, which is released during breastfeeding, can increase the body’s ability to burn fat for energy, which can help women to lose weight.

Keep in mind that having sufficient nutrition will be important to maintaining a good quality milk supply, so prolonged fasting or very rapid weight loss diets are not recommended, especially if you plan to breastfeed.

Get good sleep

Doing your best to get good sleep is incredibly important for new mothers, particularly in the early months after giving birth. Here are a few reasons why:

Physical recovery: Giving birth is a physically demanding process, and new mothers need plenty of rest in order to recover from the physical strain. Lack of sleep can delay the healing process and increase the risk of complications.
Mental health: Sleep is crucial for maintaining good mental health, and lack of sleep has been linked to increased risk of postpartum depression and anxiety.
Breastfeeding: Many new mothers choose to breastfeed their babies, and getting enough sleep is important for maintaining milk supply and ensuring that both mother and baby get the nutrients they need.
Weight loss: Good sleep is also important for weight loss after pregnancy. Lack of sleep can disrupt hormones that regulate appetite and metabolism, leading to increased cravings for high-calorie foods and reduced energy for physical activity. In fact, research has shown that sleep deprivation can make it harder to lose weight after pregnancy.

Getting good sleep as a new mother can be challenging, but there are some things you can do to help:

Prioritize sleep: Make getting enough sleep a top priority, even if it means letting some other things go.
Nap when the baby naps: Take advantage of opportunities to nap during the day, even if it’s just for a short time.
Establish a bedtime routine: Creating a bedtime routine can help signal to your body that it’s time to sleep. This could include things like taking a warm bath, dimming the lights, and reading a book.
Ask for help: Don’t be afraid to ask friends or family members for help with caring for the baby, so you can get some rest.
Share nighttime duties with your partner: If possible, share nighttime duties with your partner so that you can each get some uninterrupted sleep. For example, one of you could handle feedings while the other sleeps, and then switch off.
Create a sleep-friendly environment: Make your bedroom as comfortable and relaxing as possible, and try to minimize noise and other distractions.

Get support

If you’re fortunate to have relatives or other individuals who are willing to help you during and after your pregnancy, let them know of your efforts to keep your weight under control following your pregnancy.

Let them know the diet you plan to follow, and ask them to keep you accountable, or even provide those types of meals!

Weight gain after pregnancy is not often due to the pregnancy itself, but rather the lifestyle changes that typically accompany the arrival of a new baby. Caring for a newborn can be incredibly demanding, both physically and emotionally, and many new moms find that they have less time and energy to devote to their own self-care.

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Citations

Childbearing and Obesity in Women: Weight Before, During, and After Pregnancy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2930888/

Eating right during pregnancy. https://medlineplus.gov/ency/patientinstructions/000584.htm

Postpartum Weight Retention Risk Factors and Relationship to Obesity at One Year. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4286308/

Pregnancy Calorie Calculator. https://www.freedieting.com/pregnancy-calorie-calculator

Pregnancy Weight Gain Calculator https://health.canada.ca/en/health-canada/services/food-nutrition/healthy-eating/prenatal-nutrition/pregnancy-weight-gain-calculator.html

The Best Ways to Lose Weight After Pregnancy. https://www.livescience.com/53768-how-to-lose-weight-after-pregnancy.html

Weight Gain During Pregnancy. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-weight-gain.htm