Bump at 31 Weeks

Do Guidelines Promote Excessive Weight Gain in Pregnancy?

Weight gain is a key feature of a normal, healthy pregnancy. But it’s also a tricky subject that comes back to the core question of what’s normal and healthy. Good nutrition is important for both mother and child. Too little or too much weight gain can bring problems. Two new studies shed some light on the risks for excessive weight gain during pregnancy.

A Close Look at Guidelines and Individual Needs

Jasper Most and colleagues took a close and very careful look at the individual energy needs of 72 mostly healthy women with obesity. They were all in their first 13-16 weeks of pregnancy. Women who already have obesity face an especially high risk of excessive weight gain and other complications during pregnancy.

What Most found was tremendous variability in the energy needs of these women. Overall, they were relatively inactive. The calories they burned while asleep added up to about 70% of their daily energy needs. One woman might burn nearly twice as many calories at rest compared to another. And body composition –relative amounts of fat and muscle – explained most of that variation.

Unfortunately, the researchers found that standard estimates of daily calorie requirements for these women were way off. On average they needed 400 fewer calories than guidelines suggest. For pregnant women with obesity, current guidelines may be promoting excessive weight gain.

Loss of Control

In the American Journal of Clinical Nutrition, researchers report that more than a third of a large group of mothers experienced loss of control over eating while pregnant. Perhaps more important, they found that women who reported those experiences had children with twice the risk of excess weight and obesity. Loss of control over eating is a key symptom of binge eating disorder.

Weight gain during pregnancy is a subject that is both important and challenging to understand. These new findings suggest we need to step up to the challenge.

Click here for the study of energy requirements and here for the study of loss of control. For further perspective on the latter study, click here.

Bump at 31 Weeks, photograph © steph / flickr

Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.


June 7, 2018

2 Responses to “Do Guidelines Promote Excessive Weight Gain in Pregnancy?”

  1. June 08, 2018 at 12:13 am, Michael said:

    ‘Loss of control’ is an interesting phrase. It infers cognitive control is key to weight control. Unfortunately most of the evidence suggests cognitive control is a weak tool for long term weight control for most people. Sadly most dietitians/nutritionists working in weight loss (being less prone to obesity themselves) tend to overestimate the power of cognitive control. Hopefully we will get to the point some day when the influence of willpower over weight will be recognised as being on par with the effect of willpower on blood CO2.

    • June 08, 2018 at 3:19 am, Ted said:

      I agree with you generally, Michael, but I’m wary about generalizations. Cognitive control seduces many people in many professions. On the other hand, many dietitians are very sophisticated about its limitations.