Gaining weight is an important part of pregnancy and being affected by obesity does not exclude you from this fact. Additionally, just as for individuals with normal weight range during pregnancy, the amount of weight gain should be regulated. Gaining more or less than expected can have a negative impact on the mother and baby and can also be a tell-tale for something going amiss with the pregnancy.
What is obesity?
Obesity is a measure of body fat based on your weight and height. You are considered obese when you have a Body Mass Index (BMI) of 30 and above. To get your BMI, you must divide your weight in kilograms (kg) with your height in meters (m) squared.
Here is the scale to determine which weight range you fall in after you calculate your BMI.
Less than 18.5- underweight
18.5 and 24.9- normal body weight
25 to 29.9- overweight
30 to 39.9- obese
40- severely obese
Why am I gaining weight?
It is important to note that most of the weight you gain is related to the baby. Only some of it will contribute to your body fat.
The pregnancy related factors that contribute to your weight gain are:
Your breasts become larger
The baby is growing bigger
Fluid surrounding the baby is increasing in volume (amniotic fluid)
Your blood volume increases
The placenta grows bigger
The uterus growth
Body fluids
How much weight gain is normal during pregnancy when I am obese?
To determine the amount of weight you should gain, your doctor needs to take into consideration your BMI before pregnancy and how many babies you are carrying in the index pregnancy.
According to the American College of Obstetrician and Gynecologists, the weight gain recommendation for a woman affected by obesity with single pregnancy is 5-9kg and multiple pregnancy is 11 to 19 kg.
It may be that you gain little to no weight in first trimester. In fact, some women lose weight during the first trimester. It is nothing to worry about if you are still within normal body weight. More weight is packed up during the second and third trimester.
Please note, you do not have to go out of your way to gain or lose weight. Instead, it is recommended that you pay attention to what you eat (nutritious, balanced diet) and stay active. Your doctor may refer you to a dietician to help with the meal or foods you should be eating, and may suggest an appropriate and safe exercise programme for you.
Why is it important to know how much body weight I am gaining?
Gaining the right amount will protect you and your baby.
Gaining too little weight is associated with:
Delivering prematurely
Having a small baby
Gaining more than recommended is associated with:
Having a big baby (macrosomia)
You may deliver via caesarean section
How can I manage my weight gain during pregnancy?
As already established, exercise and healthy food choices form the basis of healthy weight gain and results in a positive pregnancy outcome. Therefore, yes! You can still have a healthy pregnancy with obesity. It will require good antenatal care, an exercise routine, healthy diet, and better planning for delivery.
Here is what you can do to manage your weight gain:
Exercise
If you were exercising before pregnancy, keep it up. If you never used to exercise prior to pregnancy, it’s important to start now for a healthy pregnancy. You don’t have to do hard activities. You may take walks, or swim (if it’s something you used to do). You may exercise for 15 minutes, three times a week and increase to 30 minutes, 5 times a week. Adjust to your ability, and build up gradually.
Eat healthy (including appropriate portions)
A common pregnancy myth is that you must eat for two. You don’t need to eat for two. Just ensure that you follow a healthy, balanced diet. Your doctor may work out how much calories you need per trimester.
This article is written by Dr Katleho Tau (MBChB-UKZN)
References:
1. March of dimes. Weight gain during pregnancy. [internet]. March of dimes. 2020. Avail from: https://www.marchofdimes.org/pregnancy/weight-gain-during-pregnancy.aspx
2. Tommy’s. How much weight should I gain in pregnancy. [Internet]. Tommy’s. 2021. Avail from: https://www.tommys.org/pregnancy-information/im-pregnant/weight-mamnagement/how-much-weight-should-i-gain-pregnancy
3. MedlinePlus. Managing your weight gain during pregnancy. [Internet]. MedlinePlus. 2020. Avail from: https://mdelineplus.gov/ency/patientinstructions/000603.htm
4. Mayoclinic. Pregnancy and obesity: Know the risks. [Internet]. mayoclinic. 2022. Avail from: https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-and-obesity/art-20044409
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