Eating for Two

As soon as I got pregnant with my daughter, the advice started rolling in.

“Stop running.” “Don’t exercise.” “Eat more.” “You’re too skinny.”

The age-old line, “You’re eating for two,” bombarded me all day, everyday.

Pregnancy number two was no different.

We grow up with this notion that pregnancy is a blissful time when a woman should indulge her cravings. I grew up in a culture that has no expectation that a woman will return to a normal weight postpartum.

As a physician who focuses my entire life on metabolism, I know this well-intentioned advice is not only wrong; it is dangerous.

Ladies, let me be the one to break it to you – pregnancy is not the time to load up on pies, fries and ice cream. It is not the time to pack on a ton of extra weight with a plan to lose it later.

First of all, you are eating for 1.1 at max, not even close to two. My 28-week- old fetus weighed just a tad more than 2 pounds when I had my most recent oral glucose tolerance test. Sure he’s growing fast, but he does not need the 1200 calories I typically need for an average day. Eating for two will make you rapidly gain weight.

Second, all of us have increased insulin resistance during pregnancy. For some women, this manifests as gestational diabetes that needs close monitoring. Even if you are not diabetic, you become more glucose intolerant during pregnancy and this programs us to lay down fat.Worse, women who are overweight or obese are likely to gain more weight than recommended during pregnancy and to gain weight postpartum.

Third, eating right in pregnancy is hard between nausea and reflux. If we don’t try, we will fail.

Why is this important?
1. Gestational diabetes: If not well-controlled, GDM can cause birth defects, big babies with delivery complications, dangerously low blood sugar in the newborn, and increased risk of obesity and diabetes for your child.
2. Losing the baby weight is hard: Studies showed that around 20% of women have more than 10 pounds hanging around long-term after having a baby. Excessive pregnancy weight gain and postpartum overweight directly correlate with overweight decades after pregnancy leading to detrimental health consequences.

3. Your child’s long-term health: Kids whose moms were overweight or obese while pregnant are pre-programmed to be at higher risk for obesity and type two diabetes during their lifetime due to persistent high insulin levels transferred during gestation.

Recs:
– Eat nutritiously during pregnancy – avoid processed foods
– Talk to your OB about recommended weight gain
– Stay active during pregnancy
– Get enough sleep
– Work on stress management
– Invest in your partner for support

Gunderson, Erica P. “Childbearing and Obesity in Women: Weight Before, During, and After Pregnancy.” Obstetrics and Gynecology Clinics of North America, vol. 36, no. 2, 2009, pp. 317–332., doi:10.1016/j.ogc.2009.04.001.