to think that the NICE guidelines on obesity and pregnancy are just yet another way of pissing off pregnant women?

(257 Posts)
PerfectDromedary Wed 28-Jul-10 08:57:30

I'm 9 weeks today, and trying to enjoy a first, very much longed-for pregnancy. But as far as I can work out, NICE is out to get me - and the 40% of pregnant women who are overweight/obese when they conceive.

Am I being unreasonable to think that the medical profession has just put on their judgy pants about yet another aspect of women's behaviour while pregnant? It seems highly unlikely that going on a diet while pregnant is a good idea - plus, if I don't have something in my stomach at all times, I'm quite likely to throw up...

(NB I may also be a little bit hormonal. But seriously, ffs.)

Altinkum Wed 28-Jul-10 09:00:10

Have they said diet? or more likely healthy eating? as if they are overweight/obese, then they are maybe not eating a healthy diet

sarah293 Wed 28-Jul-10 09:01:57

Message withdrawn

Bonsoir Wed 28-Jul-10 09:02:09

No-one is out to get you. It is much easier and less risky to be pregnant and give birth if you are a healthy weight - weight guidelines are an encouragement to help yourself enjoy your pregnancy and birth to the full.

CMOTdibbler Wed 28-Jul-10 09:02:28

Um, no. They review the evidence on what puts women and their babies at greater risk of complications during pregnancy and birth, find that obesity is a significant factor, and recommend that maybe women and their caregivers need to think about this.

The advice for a number of years has been to avoid putting on weight in pregnancy if you are already overweight - it's not dieting, just keeping your calorie in/out the same so your fat will be used to grow the baby

dinkystinky Wed 28-Jul-10 09:05:33

OP - enjoy your pregnancy regardless of the NICE guidelines, but keeping an eye on your diet to ensure you eat healthily, and staying active and having a healthy lifestyle, is something all pregnant women are encouraged to do to help them have an easier pregnancy and birth, not just overweight mothers to be.

Firawla Wed 28-Jul-10 09:07:11

still enjoy your pregnancy! but i dont think they say these things just to piss people off, it's because they are true and it does put you more at risk of various things. for eg risk of gestational diabetes is higher isnt it? doesnt mean you will automatically get everything though, its just something for people to keep in mind.
if you want to diet i think you can do ones like slimming world during pregnancy too, they wont starve you its just healthy eating

PerfectDromedary Wed 28-Jul-10 09:08:13

I'm not an idiot. I do understand the point of healthy eating.

But I'm also aware that I've been putting on weight in the first few weeks of pregnancy because I am eating constantly to stop myself from throwing up - which must be the case for lots of other people, I don't think I'm just greedy.

I'm also not sure about the conflation of obese and overweight that seems to have happened within the guidelines.

TheCoalitionNeedsYou Wed 28-Jul-10 09:08:38

Yes NICE was set up to find ways to persecute people. It's only aim is to make things as difficult as possible for everyone and in no way bases it's recomendations on an analysis of the available research. If you don't like what they say it must be because they are wrong.

Galena Wed 28-Jul-10 09:09:08

I'm morbidly obese but eat a healthy diet.

YANBU and I agree, it's just yet another stick to beat people with.

Everyone, but everyone who ever gave a shit about their life and/or that of their baby's life knows this stuff already. hmm

BUT, and this is the bit I find highly biscuit -worthy is that seriously, so imagine you've been overweight all your life, then you decide to TTC and lo and mighty behold, the weight just falls off and you stick to diet and exercise. Well fuck me ragged, why didn't I (they) simply lose the weight before? Perhaps I was just waiting for the NICE guidelines to tell me so.

<passes drom a large G&T, a M&S risotto and a Marly>

PerfectDromedary Wed 28-Jul-10 09:11:11

TheCoalitionNeedsYou NICE does have form in making very sweeping recommendations based on the fact that women are stupid, though - cf. all the debate on this site about whether or not you can have a drink in pregnancy.

Sounds like you have a chip on your shoulder.

"It seems highly unlikely that going on a diet while pregnant is a good idea"

Well actually foetuses (sp?) are like little parasites and will suck up all the good stuff they can. If you are obese then cutting down your calorie intake (while having a balanced diet of course, not a 'mango and maple syrup' deit or anything silly like that) will most likely do you and the baby good.

That's a generic you, by the way, because people laugh at me when I say 'if one is obese'

theaudiconnection Wed 28-Jul-10 09:15:35

In what way are they out to get you?

I was a healthy weight at the start of my first pregnancy but got pregnant quite soon adfterwards and was a bit overweight at the start of my second pregnancy.

I can assure you that nothing has ever been mentioned to me about my weight in 9 months of antenatal appts with m/ws and consultants.

TheCoalitionNeedsYou Wed 28-Jul-10 09:15:35

PerfectDromedary - No the guidelines are based on what effect making different recommendations has. You get fewer people drinking unhealthily if you recommend abstinence than if you recommend a limit. This is because people are stupid except when it comes to deceiving themselves.

Or maybe NICE is a tool of patriarchal oppresssion I don't fucking know do I?

PerfectDromedary Wed 28-Jul-10 09:15:56

Trillian Of course I have a chip on my shoulder. I've been trying to conceive for 20 months and now I'm starting to dread going to midwife appointments because they'll lecture me on something I already know is a bad idea. Like Ski said, it's not like women who have struggled with their weight all their lives don't realise that it's a bad idea to be massively overweight when pregnant - but like everything else, it's not necessarily within your control.

And have you tried cutting down your calorie intake in the first trimester? I'm not living on pots of Ben and Jerrys/pizza/chips and kebabs, but I'm still coming in at at least 300 calories a day beyond what I should be eating because constant snacking, even on fucking oatcakes and apples, mounts up.

starkadder Wed 28-Jul-10 09:21:57

I don't think YABU at all. Of course people should be healthy, of course mothers shouldn't use pregnancy as an excuse to gobble loads of cakes all day long, etc etc etc...of course it's generally a crap idea, from a health point of view, to be fat.

BUT the article I read on the subject (in the Guardian) irritated me as well. All about how women mustn't put weight on but, of course, mustn't try to lose weight too quickly after giving birth either...

I actually lost weight overall (not counting weight of actual baby..!) during my pregnancy but I still read the article and thought... ^why can't they just leave us alone!!^

So, YANBU.

saltyair Wed 28-Jul-10 09:22:07

BeautifulCamel Just thought I'd pop my head round the door to offer my support!!

Incidentally, you do know that wearing make up and walking past cheese shops also means you are a bad person, now don't you?? grin

notyummy Wed 28-Jul-10 09:27:50

I have just started another thread on this (but In the News, rather than AIBU...so not as popular!!)

here

OP - you are not alone, as many of the women that I have seen posting on the 'over weight' threads before seem to be outraged that anyone should issue guidance to try and make pregnancy and childbirth safer....

mollycuddles Wed 28-Jul-10 09:30:39

Having just completed a pregnancy as a heifer I have some sympathy with the OP. There is no point lecturing someone about their weight at every appointment. In total I put on about a stone in the pregnancy and at 9 weeks I already weigh less than I did before getting pg. I didn't start putting on weight until about 26 weeks and I was careful with what I ate the whole time but it's an easy thing for any control freak hcps to focus on. I didn't get high bp or gestational dm but the risk was/is real so I was happy for the extra checks/tests. My blood sugar was borderline but a low gi diet stopped it creeping up further and dd2 came out at 50th centile for growth. Gestational dm is serious so it's good to be aware even before it could happen - make sure your snacks to counteract the sickness are low gi - oatcakes with cheese or almonds were good for me. I was a bit annoyed at the ruling re the midwife led unit being out of bounds as NICE lumps all mlus together and although I wouldn't have gone to the unit that's 30 mins from the nearest obstetrician I can't see why I wasn't allowed to go to the mlu one floor down from labour ward. Especially as despite all my protests and the fact that there were no antenatal complications the midwife kept trying to insist on all sorts of interventions and was pushing pain relief I didn't want. This was in a 3 hour labour. All sorts of other issues with the mw but that can happen anywhere. I also had to see an anaesthetist because NICE say so which was pointless. He insisted I had to put in my plan other pain relief apart from gas & air and cited evidence about obese women and pain relief but dd1 was born with just g&a so I found his attitude patronising. Dd2 was born with just g&a. But if I'd been less confident or had a less good birth partner (thanks dh) being on the obese protocol would have made the birth harder and possibly with unnecessary interventions as hcps can get caught up with protocols instead of looking at individuals.
Anyway OP yabu but I understand your frustrations

ChoChoSan Wed 28-Jul-10 09:30:55

Hello Perfection

I have been stuffing my face with bad stuff since pg during the week, then eating lots of fruit and veg at the weekend, with a nice relaxing glass of wine! I am lucky to have suffered very little with MS, but a friend of mine had hyperemesis, and all she could eat was sweets. Guess what...she was fine.

NICE are not out to get you, but if you post in AIBU, someone else might well be grin.

I think that making assessments based on over-weightness and obesity alone might prove to be relatively unhelpful in the long run, as increasingly it is body shape that is an issue...health problems occur more in those with low hip/waist ratios such as myself than in the hourglass curvaceous types such as yourself.

This means that, although I am (teetering on the edge of) a healthy BMI, I am likely to suffer more health problems/heart problems that my so called 'obese' BF who has it all goin' on with the tits'n'ass, simply because, though I have big breasts, there is not much between my hip and waist measurements.

Anyway, I shant worry about it to much, as we will all be a very long-lived generation overall, and have relatively healthy lifestyles. Relax and enjoy your pregnancy - hopefully your MS will soon pass, and NICE will send you a badge to say what a good girl you have become.

PerfectDromedary Wed 28-Jul-10 09:33:31

Have just been over to your thread, notyummy. How about we send all the fat people to pregnancy bootcamp? Or maybe prepackage all their meals for nine months to ensure that they are totally infantilised?

Of course, we'd have to work out how to define fat first. Waist to hip ratio? BMI? Or just pointing and laughing?

coraltoes Wed 28-Jul-10 09:35:19

I think they have to put this message out there as loudly as they can, as sadly obesity and unhealthy eating is out of control in modern society. Your calorie intakae may be higher because of 1st trimester snacking (i know mine is) but that shouldn't tip you into the dangerously overweight category...if it does it suggests you were too close to it already.

The trouble is there are way too many women (and men and children) who really do live on junk food, regardless of being pregnant or not, and it is crucial to make them aware of the damage this does to an unborn child who is dependant on mum for nutrition. If you think it doesn't apply to you, then it probably doesnt but you have to appreciate not everyone is the same as you and some people really do need it spelling out for them.

Nobody is saying to diet in pregnancy, and there is also a crucial message of not crash dieting afterwards but to take a more long term healthy approach to food and weight! Hardly a negative message!

MathsMadMummy Wed 28-Jul-10 09:36:21

just eat healthily and take (reasonable) exercise. you'll probably be tested for gestational diabetes.

it is extra important to be fit in preparation for the birth as the uterine muscle is weaker IIRC

Chil1234 Wed 28-Jul-10 09:38:19

I'm surprised no-one's seen the potential for an ulterior motive. Our old friend cost saving! If it's now officially recommended that women should aim to be a healthy weight prior to conceiving in order to reduce their risk of problems during pregnancy (and we can't argue with that surely?).... the next step will be that fertility treatment will not be available to women until they reach a healthy weight.

Cost-saving both in having fewer women hospitalised during pregnancy and cost-saving in the reduction of provision of fertility treatment.

YABU to think it's all about pissing off you....

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