Very Low Weight Gain or Weight Loss Not Recommended for Most Obese Pregnant Women

Well, some do not. And some do.

Very low weight gain or weight loss is not recommended for most obese pregnant women, according to the results of a cohort study reported online March 31 in the American Journal of Clinical Nutrition.

"Some clinicians have been pushing weight restriction for all classes of obese women," lead author Lisa M. Bodnar, PhD, MPH, RD, an assistant professor of epidemiology, obstetrics, and gynecology at the University of Pittsburgh in Pittsburgh, Pennsylvania, said in a news release. "Our study indicates that a single standard for optimal weight gain for obese women may not fit the bill. Instead, we need to consider level of obesity and advise women accordingly."

Because of the lack of data to inform weight gain guidelines by obesity severity, the 2009 Institute of Medicine (IOM) Committee to Reevaluate Gestational Weight Gain Guidelines recommended that all obese pregnant women gain 5 to 9 kg at term. The goal of the present study in obese women who were stratified by severity of obesity was to evaluate associations between gestational weight gain and small-for-gestational-age (SGA) births, large-for-gestational-age (LGA) births, spontaneous preterm births, and medically indicated preterm births...

With increasing severity of obesity, the prevalence of excessive gestational weight gain decreased, and weight loss increased. Weight loss tended to predict SGA, medically indicated preterm births, and spontaneous preterm births, whereas high weight gain was linked to a higher risk for LGA and medically indicated preterm births. Probabilities of SGA and LGA were 10% or less, and the risk for medically indicated preterm births and spontaneous preterm births were minimal with weight gains of 9.1 to 13.5 kg for obesity class I, 2.2 to 9 kg for obesity class II, 2.2 to less than 5.0 kg for obesity class III white women, and less than 2.2 kg for obesity class III black women.

"These data suggest that the range of gestational weight gain to balance risks of SGA, LGA, sPTB [spontaneous preterm birth], and iPTB [medically indicated preterm birth] may vary by severity of obesity," the study authors write.

Limitations of this study include observational design, incomplete data on outcomes related to weight gain and on longer-term infant outcomes, lack of data on the pattern of weight gain, and lack of data on gestational diabetes or preeclampsia.

"Obese women may face increased complications of pregnancy," said senior author Barbara Abrams, DrPH, RD, professor of epidemiology, maternal and child health and public health nutrition at the University of California, Berkeley. "Appropriate weight gain may lessen these risks for the baby, so we strongly encourage all obese women to receive nutrition and lifestyle counseling throughout their pregnancies."

Either way, they have no idea what is "right."

Better to dissuade the fat from having kids since fatsos put themselves and their kids at risk.