The facts and figures
63% of the UK population are classed as obese. 75% of hospital obesity treatments are for women. 1 in 5 pregnant women in the UK are obese. In my clinic I offer bespoke weight-loss programmes to women to improve fertility, maintain a healthy pregnancy weight and prevent the trend to gain weight consistently post-delivery.
Additional training and qualifications in obesity and weight management can help you support and educate women and families about the effect of obesity on fertility. They should be made aware dangers to them and the foetus in pregnancy and labour can have a significant impact on reducing the complications as well as reducing the risk of childhood obesity.
Losing weight and maintaining women's health post pregnancy can be complex because of the additional factors associated with hormones, lifestyle, and stress. For first time mums very often, it is as if their whole world has exploded. For second and subsequent time mums it can feel like a tsunami of exhaustion because this time they have had someone else to look after throughout pregnancy and then suddenly they must manage one or more small children with all the demands of a new-born. For some there is the added pressure of living in a challenging socioeconomic environment that significantly influences lifestyle choices.
The focus should be on educating patients about food types; carbohydrates, protein, fibre, and fat and also include discussions around Ultra Processed Food (UPF) and its effects on the body. Supporting patients to make small changes at a time that can have a significant impact on their progress and help them remain positive and maintain the desire to continue with the process of creating new healthy habits.
Preparation is key
Firstly, I encourage them to consider the huge number of adaptations their body has had to go through right down to the cellular level to be able to get pregnant, sustain a pregnancy, nourish the body, and prepare it to nourish the baby, whether breast feeding or not. On top of this the body must carry on as normal.
We discuss the changes in hormone levels and how they are not only responsible for sex drive, maintaining the menstrual cycle and emotional state but are also intrinsically linked to regulating appetite and where in the body fat will be stored.
I reassure patients that gaining weight in pregnancy is normal and essential but, it is not necessary to overeat or adopt the mentality that this is an opportunity to eat anything and everything including all the foods they may have avoided prior to pregnancy to maintain a healthy weight.
The importance of education
We review how the loss of any excess weight will reduce the risk of complications not only in pregnancy but at delivery and talk through the risks associated with obesity in pregnancy including gestational diabetes, pre-eclampsia, pregnancy induced hypertension, post-partum haemorrhage and shoulder dystocia.
I help them to see this as an opportunity to become as healthy as possible and if I am meeting patients prior to conception I discuss with them the advantages of getting in shape beforehand. I explain that they are about to put their body through potentially the most demanding process it has ever experienced so preparation is key.
It is especially important to reinforce the message that implementing changes to diet and exercise is about “getting healthy” not “getting thin”. Good balanced nutrition is key and one of the main problems is that generally women are not eating enough. Too many are attempting to survive on an ultra-low-calorie diet which is not sustainable or healthy.
Shifting emphasis so that the change in shape, loss of weight is a by-product of the process psychologically can be a game changer especially for those patients who have tried many ‘diets’ before and are stuck in the ‘diet cycle’.
Empowering women to realise the importance of regaining pre-pregnancy weight and fitness levels can halt the slide into ever increasing weight gain is without doubt a sensitive area but one that shouldn’t be avoided in a bid not to offend patients.
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