Confused about NICE warning re weight gain . . . a load of rubbish?

[Honeybee79]

Hi there

I read the latest NICE press release on weight gain. Lots of it makes perfect sense, for example trying to ensure that you are a healthy weight when you conceive. But it then seems to say that women should avoid becoming overweight or obese during pregnancy by reference to BMI.

I know it's not good to gain excessive weight during pregnancy but surely we're supposed to gain a decent amount? And if you were a healthy BMI of 22 or 23 when you conceived and you then gained about 2 stone over the course of the pregnancy then that would make you "overweight" according to your BMI. Surely by the time you're 8 or 9 months pregnant it's kind of inevitable that you're going to have a BMI that puts you in the overweight/obese category for non-pregnant women . . .

Am confused. It doesn't help that I have had issues with my weight in the past. I was slim when I conceived and have decided not to weigh myself throughout the pregnancy and just try to eat and live healthily. But this NICE stuff is making me paranoid and worried

Does anyone have any thoughts or advice on this?

Hi - I would say try not to worry too much. I'm sure they can't mean that you have to stay within the non-pregnant BMI weight range as that would be impossible - we've got a lot of baby, placenta etc to grow after all!

I found this Pregnancy Weight Gain Estimator online:
www.babycentre.co.uk/tools/weightgain/
which tells you how much you can expect to gain, based on your pre-pregnancy weight. Apparently I'll be about 2st heavier by the end.

There's a general (non-pregnant) BMI calculator elsewhere on the site too.

Not getting weighed too much sounds like a good idea - I haven't got scales and just hop on at the gym occasionally. I hope I'd be able to tell from my face, arms etc if I was putting much weight on anywhere except my bump.

Hope this helps - don't worry, just eat what you know is sensible. And congrats on your pregnancy!

Hi Honeybee 79- I was quite annoyed by that news announcement when I heard it as I thought it was unclear/misleading. I understand that if you're already overweight and gain a lot of weight during pregnancy that this could lead to complications to yourself or your baby, but for those who aren't overweight, I think it's just making us feel guilty for eating more. In the news report I heard, the doctor questioned said that women shouldn't eat more during pregnancy apart from perhaps 200-300 calories more in their last trimester. Try telling that to a ravenous pregnant woman! I'm only 13 weeks and cant' eat enough I'm so hungry- surely hunger is a sign that our bodies need more food?

I wouldn't worry about it- I think as long as you eat sensibly and try and stay active then you'll be doing the best for yourself and your baby. I think there's enough worry about keeping slim when not pregnant and I'm annoyed that this news article may make pregnant women cut back and not eat enough.

BMI is not appropriate for use in pregnancy. It never has been and I have no idea why midwives use it. If you look at the maths BMI actually assumes us to be 2-dimentional (and pregnant ladies certainly aren't). It also doesn't take into account body composition (i.e. muscle:fat or water retention). At best it is vague and it can be dangerously misleading.

I'm also not convinced by that online calculator. I think what you need to do is eat a healthy diet, if you feel hungry, then you need to eat, and as long as you are eating good healthy stuff, not junk.

I have gained far more than I am "supposed to" but somehow managed that on mostly fruit, yoghurt and milk! Otherwise my diet has been on the healthier side of what I ate before I was pregnant, when I was a healthy weight.

Porcelain I'm so glad DH and I are not the only ones to notice that BMI measures you as though you are two dimensional.

Honeybee, I wouldn't worry too much about it. As long as you are feeling all right in yourself, you should be all right. I'm 19+1 today and earlier in my pregnancy was referred to a nutritionist because my BMI was high. However, once the nutritionist had actually seen me and spoken to me, she turned the whole thing into a training exercise for the student midwife on how to assess the person not the number as I was happy and, judging by my BP and protein counts, quite healthy.

So if you are hungry, eat.

SaraL77 I actually posted earlier about feeling guilty about having an increased appetite. Luckily, Msnetters responded and said I ought to eat if I felt hungry but before I posted that, I was definitely headed the other way. And I was mostly just eating salad and fruit! Only things that wouldn't make me nauseous you see.

I watched this on the news while stuffing my face with chocolate. I think a lot of people overeat because they feel they have an excuse.

The way I look at it, if it's what your body is craving, then eat it, healthy or not. They are called cravings for a reason. It's your body telling you you need something. i have my days where I stuff my face all day, but then I have days where I'm only snacking a bit through the day eating barely anything.

I just do what my body tells me to and if anyone tells me that i shouldn't be putting on a lot of weight, (which I have) then they are obviously men or childless women and can buggar off

LouM10 - did you see the research that said that mums who ate chocolate had happier babies? I think that is a good enough excuse for a bit of decent quality chocolate now and again!

I think you really have to have a healthy attitude towards food, stressing about it isn't going to help. Unless you are stuffing your face with crisps and cake all day, every day, you are probably ok, I don't think my baby would have let me do that, I crave milk and pineapple!

Besides, you could be calorie counting but getting your calories from rubbish without the nutrients your baby actually needs.

I am sure my baby will appreciate my extra bum-fat when it is making up his feeds

Exactly. It's not as if you can put on that much weight in 9 month anyway. Well you can, but you can't go from 'normal' to obese. I am lucky that I am 5'10'' so I have to put on a lot of weight for it to show. I have only went up one dress size (all on my bottom half I may add. Legs like tree trunks and an arse to match J Lo's hehe) so not that bad really.

And as far as chubby babies go, I think chubby babies look a bit healthier than skinny babies. However, my DH is 6'6'' and like a rake so I have a feeling mine is going to be a long skinny baby, so I feel it is my duty to eat more to try and fatten him up. hehe. My excuse and I'm sticking to it

the guidence is based on women with a bmi of 30 or more at the beginning of pregnancy.
not based on healivily pregnant bmi.

My MW checked my BMI at my booking in appointment. I had already put on 5 kg by then and it took me up to a BMI of 30 (I should add I was very healthy at the time, and still walking 20 miles a week plus 3 hours of dance training). She never asked for my pre-pregnancy weight, which would have given a BMI of 26. She told me I was obese and flagged me up for extra glucose tests and stuff (total waste of my time).

Porcelain - just like me.

DH suggests that a measure with units of kilograms per cubic metre would be much better than one with kilograms per square metre. (How dense you are - as fat is the lowest density tissue)

Or they could look at you and think "is this woman fat?" No - then lets not worry about it

Well, that's true, too. I suspect that's what the nutritionist did with me. Or try and determine is this woman healthy?

i dont get the whole thing with BMI anyway - my son weighs an absolute tonne, everyone we know comments on how heavy he is, BUT he is really skinny - you can see his ribs. His BMI is more than likely quite high.

Thanks very much for your responses - very helpful and reassuring!

LLKH as you said, it just goes to show that the numbers are often pretty meaningless each person should be looked at as an individual.

BMI in pregnancy is just stupid infact I hate the whole BMI thing.

Hubby is obese apparantely yet has stacks of muscle and runs 5 miles a day and tops his fitness test what a joke.

I hate the pregnancy weight gain nazis. Eat your 5 a day and also eat cake and stay active and ignore the stupid British right-wing media. Simples.

TBH when my mother was pregnant in the 60s, women's weight was monitored much more closely from what she tells me - she was weighed every visit and given long faces if she gained more than a very defined amount. My poor MIL was advised to lose a lot of weight in the third trimester, which she did, and which is just ridiculous IMO

The NICE guidance, in contrast, is about trying to help women with a BMI of 30 or more lose weight before getting pregnant, and advises that it is not a good idea to try and lose weight during pregnancy.

Sorry, but I would never discount NICE guidance completely, though I'm sure it's no more absolutely perfect than any other institution.