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What is Pregorexia?

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How many times have you heard your postpartum friends or clients lamenting the loss of their svelte “pre-baby” physique? The cultural norm in our society is to “get your body back” as soon as possible. And the sooner, the better!  Genes may help a few of us lose those extra pounds quickly, but most women are bound to sweat in the gym for hours and severely restrict their diet in order to achieve that pre-baby look quickly.

Prego-what? The dangers of pregorexia.

Dramatic weight loss measures during the first months after delivery may harm the mother and decrease the likelihood of successful breastfeeding. However an even more dangerous trend is limiting pregnancy weight gain with the hope of never facing the postpartum weight loss struggle. Such behavioral patterns are termed “pregorexia”, which was coined by the media in 2008 (Mathieu, 2009).

According to research, the consequences of insufficient weight gain during pregnancy are strikingly similar to those related to excessive prenatal weight gain. Babies born to women who did not gain enough weight during pregnancy are more prone to suffer from coronary heart disease, type 2 diabetes, stroke, hypertension, obesity, glucose intolerance, and cardiovascular disease later in life. Additionally, babies born with low birth weight who then display rapid catch-up growth may have a greater risk of metabolic syndrome in adulthood (Roseboom, de Rooji, & Painter, 2006).

Although pregorexia affects a relatively small number of women, a variety of things can be triggers including  extreme health-conscious behaviors, smoking, young age, or an eating disorder. The constant pressure to be thin at any cost affects emotionally women of all shapes and sizes. At such a vulnerable stage in life, it’s easy for new mothers to sink into self-loathing and depression and engage in unhealthy eating behaviors such as restriction and bingeing, which can, in fact, lead to more weight gain.

The Pregnancy Balancing Act.

The key to a healthy pregnancy is to gain sufficient weight for the optimal development of the fetus, without gaining too much. How do you know how much is too much or too little? Some doctors prefer not to discuss the delicate topic of weigh gain to prevent upsetting already stressed-out moms-to-be.

Here are the current guidelines for prenatal weight gain from the Institute of Medicine.

Pre-pregnancy BMI

Recommended weight gain

Singleton

Twins

<18.5 28-40 lbs (13-18 kg) Ask your doctor
18.5 – 24.9 25-35 lbs (11-26 kg) 37-54 lbs (17-54 kg)
25 – 29.9 15-25 lbs (7-11 kg) 31-50 lbs (14- 23 kg)
≥30 11-20 lbs (5-9 kg) 25-42 lbs (11-19 kg)

Body Mass Index (BMI) can be calculated by dividing your weight in pounds by your height in inches squared, then multiply that by 704:

BMI=weight (lbs) ÷ height (inches)² x 704

On average, a healthy weight gain during pregnancy for most women is 29 pounds, seven of which rightfully belong to the baby. The rest of the weight is distributed among increased blood volume, breast tissue, amniotic fluid, placenta, and uterus. About four pounds of retained water are expelled from the body soon after delivery. Only seven pounds are fat and protein, providing additional reserves for a healthy birth and successful breastfeeding.

Postnatal weight loss – When will it happen?

Postnatal weight loss depends on a combination of things such as genetic makeup, activity levels and eating habits. The rate at which weight loss occurs is highly individualized. Comparing oneself to TV celebrities or a slim neighbor is not an effective estimation tool.

While there’s not much we can do to influence our genes, lifestyle factors are equally important for weight loss. The focus should be on becoming healthier overall before and after the pregnancy, instead of fixating on the number on the scale.

With your doctor’s approval, start an exercise program at a reasonable intensity level a few weeks after the delivery. Long walks in the park and gentle stretching are a good place to start. Gradually increase the duration and intensity of your exercise sessions.  The American Congress of Obstetricians and Gynecologists provide an easy-to-follow exercise program on their website which can be done at home.

Eating healthfully during and after pregnancy is crucial. Check out our ABCs of a healthy pregnancy, which fish are safe and how much caffeine is too much? Then head over to ChooseMyPlate for Pregnancy for nutrition and calorie recommendations.

Finally, postnatal depression may lead to unhealthful eating and retention of weight gained during pregnancy. It is important to make sure the new mom is surrounded by people willing to share the challenges of this new 24/7 job: parenting.

To keep things in perspective, let’s not forget that the bonus for all our hard work cannot be measured in pounds, inches, or any currency. This bonus is nothing less than another amazing human being by your side. Didn’t we just get ourselves an amazing deal, ladies?

References

  1. Mathieu, J. (2009). What is pregorexia? Journal of the American Dietetic Association, 109(6), 976-979.
  2. Roseboom, T., de Rooji, S., & Painter, R. (2006). The Dutch famine and its long-term consequences for adult health. Early Human Development, 82(8), 485-491.
  3. Position of American Dietetic Association: Nutrition and Lifestyle for a Healthy Pregnancy Outcome, Journal of the American Dietetic Association Volume 108, Issue 3, March 2008, Pages 553-561
  4. www.marchofdimes.com
  5. www.iom.edu
  6. http://www.marchofdimes.com/yourbody_weightgain.html

About the Author

Natalia is a Registered Dietitian based in New York City. She has experience in Child and Family Nutrition, Weight Loss Counseling and Medical Nutritional Therapy for diabetes, cardiovascular disease, GI disorders, food allergies and women’s health and specializes in work related to feeding problems in children, pre- and post-natal nutrition and weight loss. She is the founder of Tribeca Nutrition where she offers counseling on pediatric and prenatal nutrition and offers interactive workshops for parents and health professionals on the topics of prenatal nutrition, introduction of solids, transition between textures, nutrition for toddlers, preschoolers and school age children and pediatric feeding challenges including picky eating.


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