Weight gain during pregnancy – #Con11 Revisited

Last month Peter and I attended the Canadian Obesity Summit in Montreal.  We put up a lot of posts during the conference itself, but (amazingly) we had so much content that I actually decided to save some!  Over the next couple weeks I will be posting that content from time to time, including several podcasts that I think people will really enjoy (the first to come later this week).

Today’s post comes from Dr Danielle Bouchard, and focuses on the impact of weight gain during pregnancy and birth weight on weight management across the lifespan.  This is an emerging area of intense research, and with good reason – as Danielle notes in her write-up, each additional kilogram of weight at birth increases the risk of being overweight/obese during adolescence by 60%.  As we discussed on the blog last year, losing weight before pregnancy may also dramatically reduce the risk of childhood obesity. My good friend Zach Ferraro is doing his PhD on this topic, and I have embedded a podcast of our previous discussion below (email subscribers can listen to the podcast by visiting the blog).

Thanks again to Danielle for her fantastic write-ups from the conference, which also helped us to bring some sorely needed french-language content to this Canadian blog!  And if you haven’t already, go check out her blog Ph.D. Obésité.  Enjoy!

Travis

Poids durant la grossesse, un problème pesant !

Plusieurs sessions du 2e congrès national sur l’obésité concernent le poids des femmes enceintes et le poids du bébé naissant, dont les macrosomes (bébé avec un poids supérieur à la moyenne lors de la naissance).  La plupart des chercheurs qui présentent sur le sujet démontrent que le poids pris à la grossesse est un excellent prédicteur du poids initial du bébé.  De plus, les femmes en embonpoints ou obèses ont plus de risques d’avoir un enfant avec un surplus de poids ou obèse à court et à long terme, ce qui augmente les risques que le problème d’un surplus de poids se passe de génération en génération.  Malheureusement, ont ne réalisent pas l’impact du poids à la naissance sur le risque d’être en embonpoint lors de l’adolescence ou l’âge adulte.  En fait, chaque kilogramme de plus à la naissance augmente les risques d’être obèse ou en surplus de poids de 60% durant l’adolescence.  Dans le même ordre d’idées, les mères ne réalisent pas à quel point la prise alimentaire ne doit pas être dramatiquement différente durant la grossesse.  Effectivement, les spécialistes estiment que l’apport calorique devrait seulement augmenter de 10 à 15 % dans le dernier semestre de gestation.  Bref, il est primordial de comprendre que le poids initial de la mère, la prise de poids lors de la grossesse ainsi que le poids à la naissance prédisposent tant l’enfant que la mère à un risque élevé d’être obèse à court et à long terme.

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4 Responses to Weight gain during pregnancy – #Con11 Revisited

  1. WRG says:

    I am so totally fed-up with articles such as this one.

    Guys, let’s face it: if you have a tendency to gain weight easily, you’re going to gain like crazy when you’re pregnant. I gained about forty pounds with both my pregnancies and had a monstrously hard time losing that weight. Oh, and had I drunk all the milk I was supposed to drink and eaten all the food that a “well-balanced” pregnancy diet required, I probably would have gained sixty pounds or more. BTW, my babies were either exactly at or somewhat under the average weight for a newborn. They are both now slim adolescents.

    Oh, and my husband’s colleague, who probably weighed all of 90 pounds soaking wet gained over sixty pounds with each of her pregnancies, ate junk food like crazy (her favourite food was apparently Cinnabon buns) and was back at her pre-pregnancy weight within a few short weeks of giving birth. It took me over four f**ing months to get out of my pregnancy jeans.

    Life ain’t fair and I am no longer going to take the less than veiled insinuations that women who gain a great deal of weight during pregnancy are all fat pigs snorting at the trough who should know better.

    This article is yet another example of the lie that if we all just eat healthily and exercise, we’ll all be slim and have nice slim babies.

    ENOUGH IS ENOUGH.

    Just keep on blaming and shaming. Tout le monde le fait, fais-le donc.

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    • Travis says:

      Life ain’t fair and I am no longer going to take the less than veiled insinuations that women who gain a great deal of weight during pregnancy are all fat pigs snorting at the trough who should know better.

      What?!?

      I know we all come at things from a different perspective, but this is not the first time that you’ve accused us of this sort of bias that just does not match with the content of the posts themselves or with our beliefs about the etiology of obesity.

      I assume that many of your concerns stem from the statement “les mères ne réalisent pas à quel point la prise alimentaire ne doit pas être dramatiquement différente durant la grossesse” (mothers don’t realize that food intake during pregnancy does not need to be dramatically different). I know from working with colleagues in this area that most people (pregnant and non-pregnant men and women alike) assume that pregnant women are “eating for 2″, which truly is not the case. Perhaps we should have included a second statement suggesting that this is not the primary cause of weight gain during pregnancy, but I still think that it is an important educational message to get across. As written, the sentence certainly was not insinuating anything like what you were suggesting, and I think you know that we would not promote that view on our blog.

      This post does not make any value judgement regarding pregnant women or individuals with obesity. And as we’ve discussed before, we feel strongly that obesity is the result of factors which are primarily outside of an individuals’ control – this is why we are concerned about obesity as a public health issue, as opposed to making inane arguments about “personal responsibility”. Just last week we had a post on the complex societal factors that can influence obesity, and more than once we’ve discussed (especially in the comments sections) the various uncontrollable factors that play a massive role in determining body weight. We wouldn’t do these things (or write this blog, or take the time to respond to these critiques) if we were in any way interested in shaming or blaming individuals for their body weight. By the same token, when we discuss the impact of diet and exercise on obesity, this does not mean that we somehow think that obesity is the result of gluttony and sloth.

      As I’ve said in the past, we are interested in discussing obesity-related science in a way which does not increase obesity-related stigma or bias, and if anything we want to work to reduce them. If you can offer any constructive suggestions on ways to do that, I am happy to incorporate them into our future posts. For example, if we are discussing an article that suggests that Lifesyle Factor X (diet, exercise, etc) has an impact on body weight, how can we do that in a way which does not suggest that obesity results from the lack of personal responsibility or further stigmatize individuals?

      In the meantime, these attacks that focus on imagined insinuations do little to help either of us.

      Travis

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  2. WRG says:

    Hi Travis,

    Yes, I did blow a gasket and I think it’s worthwhile explaining why.

    In today’s world, obesity has become a proxy for “badness”. Fat people are bad (lazy, gluttonous, slovenly, etc.) and personally responsible for their uniformly bad state of health.

    “Whoa!” you say. We here at OP and our guest bloggers never think nor say that.

    Well, although this is true, your words fly off the keyboard and are used for many purposes beyond your control. Scientific observations are never neutral. I won’t question the science behind this particular article, but I can tell you exactly how it will be perceived by all but a few well-meaning individuals: it will simply be used as more oil on the fire of fat hatred.

    Let me give you a perfect example of this. Yesterday, Dr. Arya Sharma wrote a post entitled “Right Goal Wrong Message”. You may very well have read it, but allow me to quote the first few paragraphs:

    “Yesterday, the Public Health Agency of Canada (PHAC) and the Canadian Institute for Health Information (CIHI) jointly released a thoughtful, insightful, and thorough report on Obesity in Canada.

    Unfortunately, the media release announcing this report promoted the rather misleading and simplistic notion that millions of Canadians are overweight and obese simply ‘because’ they are inactive and do not eat enough fruit and vegetables.

    This, as becomes clear when reading the actual 62-page report, was probably neither the intention of the authors nor that of the reviewers and consultants, who contributed to this report.

    Indeed, the actual report goes to great lengths to explain that obesity is complex and multifactorial.”

    If you publish a post that correlates excessive weight gain in pregnancy with certain effects on offspring, WITHOUT ANY CONTEXT OR COMMENTARY, what is the only message that the vast majority of people (including, I might add, scientists, who are no more immune to bias than anyone else in society) receive? Oh, those fatties, those fat, uncaring, irresponsible moms–now they’re going and messing up the lives of their children even before they’re born.

    Obesity is a minefield, where science lives cheek by jowl with hate and prejudice. I don’t think anyone denies just how hard, in fact impossible for 95% of those trying, it is to lose weight and maintain that weight loss. So how the heck is an article that simply rings even more alarm bells going to actually help a woman who is already overweight and now pregnant? It’s about as useful as posting statistics regarding crime in underprivileged neighbourhoods or amongst certain racial or religious groups without providing any context or worse yet, any discussion of how the situation can be turned around. It just feeds the flames of racism.

    I won’t suggest that you put a firewall around your blog and only let scientists in, because as I said above, scientists are just as liable to harbour prejudices than anyone else. What I am suggesting is that you spend a bit more time (and yes, I really did appreciate that article about tight-knit neighbourhoods) putting the science in context and looking for real-world solutions. And, though you know this already, I will repeat that dieting is not a real-world solution and that health does come in many shapes and sizes.

    I feel somewhat sorry about blowing up as I did, but if you put on a fat suit, walked a few miles in the shoes of an obese person and felt the constant disdain and disgust, you might understand how such a seemingly innocent little article could bring up such a well of anger.

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    • Travis says:

      Thanks for the response – much appreciated, as usual. Your comment did make me think of Arya’s post from yesterday, and I thought again of your comment when reading Arya and Yoni’s posts from this morning.

      I will do my best to include context whenever possible when discussion lifestyle-related obesity research in the future. Don’t hesitate to contact me when something like this comes up – these discussions are one of the most important parts of blogging, as this typically wouldn’t come up in academic conversations.

      Travis

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