to be completely shocked and disgusted at the leaflet I've just been given by my mw???

[mummylovesnancy]

This leaflet, titled 'Raised BMI in Pregnancy' was passed on to me by my midwife at my booking in appointment yesterday. Along with the words 'You can't have a home birth, you probably won't deliver naturally and you'll be given consultant led care.'
I'm 28, I have 2 PERFECTLY healthy children who both have perfect height to weight ratios, eat well, are active and are generally normal children. I weigh 13st and I'm 5'2 which puts me in the 'obese' catagory according to the good ol' BMI index of wonder. I have been roughly this weight and exactly this height for all of my adult life. I am overweight, I accept that, but what I don't accept is being told to read this sodding leaflet which tells me, among various other little pearlers, that:
*I will have raised blood pressure. (Not 'I may', 'I WILL')
*I will be prone to urinary tract infections. (never had one in my life!)
*'Bigger Ladies' (exact wordage) get more blood clots. (Dumb Fuck)
*Examinations will be difficult. (Why? Because you have to part all my layers of fat to get to my vag?! How fucking degrading)
*I will have restricted mobilisation. (Will I? Because I don't now, will it automatically come with being fat and preggers?)
*Putting in a drip will be difficult. (yeah because my hands are so freaking chubby.)
*Breastfeeding will be challenging (I've managed it with two babies, now because you've changed your guidelines I think I might struggle.)
And my favourite one yet:
*The risk of stillbirth or your baby dying in the first 28 days is increased in 'larger ladies' (Thanks for that one, nhs, I just had a misscarriage 8 weeks ago. Was it because I'm fat?)

It also mentions on about 7 occasions that I may want an epidural. Is that to keep me quiet?! It also offers to refer me to a dietician and a counsellor.

I have been overweight (or a larger or bigger lady, as the nhs prefers) and given birth naturally twice with absolutely no complications and one of them was a home birth. I can't believe I have to read all this shit. The idiot who wrote this doesn't even know how to place an apostrophe or comma ffs!

Does anyone agree with me that this is a disgusting, degrading, scare mongering piece of shit or am I being an unreasonable pregnant wreck??

Oh I'm sorry OP, I should have said "indulge yourself with food". I didn't realise that needed spelling out given the context. I'll remember that you're reading literally in future and try to be very exact.

Bizarre. Advocating being or becoming healthy = hating fat people?

I don't feel ashamed. Why would I.

If someone said to me "I ate a whole packet of Jaffa cakes and I enjoyed it", I'd say "how nice for you". Entertainingly on this thread it's been suggested I have an eating disorder, am greedy, can't have enjoyed it etc etc. Really negative reactions. Those are attempts at shaming Tilly, they're all there in black and white.

Focusing on weight and but using the excuse that it's all about health = fat hatred.

Original Poster, forgive me I'm not a health professional or an academic, so I'm sure my answer won't be broad enough. I know of course that this doesn't apply to every obese person. But i'll give it a go

What would you say are the causes?

Depression, low self esteem, perfectionism, childhood abuse. The human condition to a certain extent. We all have the ability to feel negative emotions. We all cope with these in different ways. Some people's coping mechanisms are healthier than others.

Over eating, under eating, bingeing, purging are ways of using food to effect your emotions.

Why is the incidence rising?

Because food is cheap, readily available and socially acceptable? (ie, far easier to buy biscuits rather than vodka or herion) Out of all substances that it possible to abuse in order to block out negative emotions, food is the easiest to get hold of and the most difficult to give up completely. Because you can't ever just give it up. You need to eat

Risk factors?

I don't know........ upbringing? example set by parents? personality type? Phsiological make up? (ie propensity to burn fat or store it?)

Symptoms?

An unability to maintain a healthy weight and relationship with food? Obesity? Depression?

Signs?

Not sure what you mean by this one?

Treatments?

CBT? Counselling? Community Support?

Prognosis?

Varies with the individual

What should health care professionals be doing about it? It's hard not to end up in the territory of dietary advice, exercise and management or avoidance of obesity related conditions.

I think a broader understanding of the relationship between mental health and obesity would help. This leaflet is a good example. I would think the majority of overweight people will either be depressed, distressed or angry with it. All negative emotions that then will be dealt with by comfort eating maybe. Not in all. Yes maybe some will be galvanised into action. But I'd doubt the majority.

Although I don't think the subject of the risks being overweight in pregnancy should not be raised for fear of upsetting an overweight person, I think that it should be approached with more understanding and support than the MW's I've encountered have had.

Like I said if people are sincere about health they wouldn't even be talking about weight except in the most extreme cases, they'd be focused on eating, nutrition and some people's unhealthy relationship with food, an unhealthy relationship which can continue even when people are supposedly a healthy weight.

Ok, in a totally wierd way I can kind of see what thunder is saying - essentially diets dont work (which I think we all know anyway). However, I think you are taking it too far thunder - yes fats are essential to a healthy diet but I think some people use this as an excuse to just pig out. Actually the amount of fat we actually need is really quite small, and 'indulging' on a regular basis is not the way to get fat into your diet!

Surely everything in moderation is the key - this means that actually no, it is not a good idea to eat a whole packet of biscuits all in one sitting, but a few are ok (therefore I am not denying yourself what you want, but yo know when to stop!).

God, if I ate whatever I wanted whenever I wanted I would be huge, and I am sorry, but I am not willing to put my health at risk, just so that I can 'indulge' myself! A bit of self control is surely a good thing.

Ditziness

I agree with a lot of what you said there, and apologies for medical language! I think it is widely accepted even in medical circles that overeating has psychological causes. The resulting obesity,though, is a very physical condition which has real medical consequences.

helpguide.org/mental/binge_eating_disorder.htm this is maybe what you're looking for OP?

"'indulging' on a regular basis is not the way to get fat into your diet!"

Who said it was. Not me.

People keep having conversations with someone who they pretend is me but is saying things I never said.

I said I ate a packet of Jaffa Cakes once and enjoyed it because it was an indulgence. I also said I didn't feel the need to do it again. From that a whole lot of people had a fit of the vapours/suffered extreme disapproval. I think that says more about them than me.

If you want to get fat into your diet eat butter, cheese, olive oil, other good oils, avocados, nuts. All healthy natural foods, which are an important part of our diets.

"Surely everything in moderation is the key"

I think that´s true.

Problem is-what´s moderation?

A small quantity regularly, a small quantity not very often....

Also, thunder you seem to think that it is a bad thing that people dont want to be really fat?! Why is this?

As someone else said earlier, the vast majority of people who are a healthy weight are that way because they eat healthily, not because they have some fucked up relationship with food as you seem to think - surely this is why it is called a 'healthy' weight.....?

I didn't say you were greedy or had an eating disorder, thunder - I can't know which it is! But to eat a whole pack of biscuits in one go, and think it's somehow a good thing, is one or the other!

Clearly, you like jaffa cakes, but there are many foods people like, but they don't eat them in vast quantities because it's greedy and actually, they may like them, but a whole pack is too much. They have a 'stop' button that prevents them even wanting to eat a whole pack.

As I said, being greedy is a minor flaw really, and one most of us experience at some point in our lives, though not necessarily with jaffa cakes :)

I think frequent greed is deeply unattractive in anyone, to be honest, and I would be worried if my children were greedy in that way. I'd be very upset if I thought they'd get to adulthood thinking that it's somehow liberating to eat a pack of jaffa cakes - I'd think their outlook was very skewed.

When I have used the word "fat" here it has been to describe excess fat on a human body, not to say we should not take healthy fats in to our bodies.

I didn't say it was liberating tiktok. I said it was enjoyable.

Maybe it's you who'd find it liberating given that you just can't seem to get your head around the idea that it wasn't a bad thing or negative to do. You seem to have a very disapproving attitude.

I like the way you say you didn't call me greedy and then go on to say how I'm greedy.

I think being disingenuous is deeply unattractive in anyone. I don't mean you of course. :)

So therefore OP, Obesity a physical and medical condition that has real medical consequences, has a physchological cause? (obv not in 100% of cases, before people start to say that they are fat and not mental ;-) )

and they are a vicious circle . once you are obese and ashamed and scared, then it becomes habit to keep those negative emotions supressed again, so yo can function on a day to day level.

It's not impossible to break out of this cycle, and bloody massive congratulations to those who have. But it's extremely bloody difficult and you need alot of support. And early pregnancy won't really be the time that it is most likely that you'll be able to do it. Bringing as it does mood swings, appetite changes, self esteem issues and fear? And certainly not with only the support of a scarey leaflet.

So I know not what this leaflet seeks to accomplish really. Apart from ticking some policy box somewhere for not much funding.

Forty per cent of UK women are on a diet at any one time Samstown. That is a fucked up relationship with food. I don't think they are all overweight either.

Also you tried to imply I was overweight and in denial upthread. Are you going to apologise for that?

from the link i gave a minute ago...

how to help an over eater...

Avoid insults, lectures, or guilt trips. over eaters feel bad enough about themselves and their behavior already. Lecturing, getting upset, or issuing ultimatums to a over eater will only increase stress and make the situation worse. Instead, make it clear that you care about the person?s health and happiness and you?ll continue to be there for him or her.

So this leaflet (and the attitude of most MWs) is pretty much an insult, lecture or guilt trip. it won't work. The pyschology of overeating isn't a secret. Why does the NHS seem to not know about it in this case? Do mental health not know maternity services phone number?

Would people prefer it if midwives did not highlight the additional health isssues that face obese pregnant women (statistically) at all?

I know I'd rather be told of any additional issues. For example as a pregnant 43 year old (sadly I can't go on a diet/healthy eating plan to lose age!) I am glad I know about the increased risk of, for example, pre-eclampsia. It means I can take positive steps to maintain low blood pressure and be sure to look out for symptoms.

I was told early on that they would highly recommend a hospital birth (as I've had miscarriages and am older) and I'm really glad about that as I wouldn't have to be blue-lighted from home or a birth centre if I needed consultant care.

I don't see why the likelihood of additional issues should not be raised in early pregnancy, whatever they are.

Thunder, you offered your example of heroic biscuit eating and your enjoyment of it as an instance of how you were not affected by the 'diet mentality' unlike all the rest of us poor saps who are....I said as a result (clearly wrongly) that you seemed to find the ability to eat a whole pack at one sitting to be 'liberating'. It's obviously simpler than that. You just did it 'cos you enjoyed eating that amount of sugar, fat, and chocolate :)

It's ok to be disapproving of things you know - just as you disapprove of the 'diet mentality' , I disapprove of greed. Greed is not a huge crime, and it's pretty universal, so I don't sweat it! But it ain't very nice....

I didn't call you greedy, or even suggest it, disinegenuously.

I said I couldn't possibly know if you were greedy (on the occasion you ate a pack of jaffa cakes) or had an eating disorder about which you were in denial.

I still don't know.

But it's one or the other, for sure!

"I don't see why the likelihood of additional issues should not be raised in early pregnancy, whatever they are."

and neither do I hairy, but it's how they are raised.

To weigh you, measure your height and then just hand you a leaflet saying that you'll need a caeserian, your baby is more likely to be stillborn etc is ludricous when dealing with an issue ( obesity) that is well linked to mental illness.

Jeez, at my first pregnancy booking in appointment the MW asked all the questions including the one about mental health, where I told her I'd been treated in an eating disorder clinic, had been on anti depressants prior to pregnancy. Then weighed and measued me and proceeded to give me that leaflet and tell me that I was having a high risk pregnancy etc. Scared me silly. I cried for days afterwards

You keep using the word liberating TikTok.

I'm going to say it again. I found eating a whole packet of Jaffa Cakes ENJOYABLE. Do I have to shout to get through to you?

I don't need to be liberated. For whatever reason I've never been in the thrall of the guilt trips about weight and food that a lot of women are on.

Are you unable to grasp the idea that eating what you want and enjoying it is possible? And that the disapproval, guilt trips and whatever else are the bit that are fucked up and harmful, not enjoying one whole packet of biscuits once in a forty-odd year life?

"I didn't call you greedy, or even suggest it, disinegenuously."

Yes you did. You did it right here:

"Clearly, you like jaffa cakes, but there are many foods people like, but they don't eat them in vast quantities because it's greedy and actually, they may like them, but a whole pack is too much. They have a 'stop' button that prevents them even wanting to eat a whole pack.

As I said, being greedy is a minor flaw really, and one most of us experience at some point in our lives, though not necessarily with jaffa cakes"

A whole pack isn't too much by the way. It was exactly what I wanted at the time. Who do you think you are to decide how much someone should eat?

There are good leaflets, sensitively written, factually accurate, and useful.

There are rubbish leaflets, written by a bulldozer, questionable in their accuracy and useless.

So far, I have not seen a link to the one described by the OP - have you a link to it, ditziness?

It's more surprising that more folk aren't obese with the amount of food (much of it crap) easily on offer these days and the fact we can lead a much more sedentary lifestyle. I agree being overweight and obese is being normalised. What we do about it I don't really know, can we do anything about it? It's so sad to see so many obese and overweight little kids, it's probably too late for many of the adults, education on nutrition and exercise would seem to be the key so maybe targetting this leaflet at mums to be is also to start getting them thinking about how they will approach their children's food and exercise.

And it's just insulting of you to say that either I have an eating disorder or am greedy Tiktok.

But as we're going there, I think you're posts are giving an impression of a very fucked up relationship to food, especially your reaction to the jaffa cake story.