Obesity and pregnancy

[RonWeasleysBackfiringWand]

I’m obese and scared of facing an unhealthy pregnancy. I have been trying to lose weight for years with no success, and have concluded that I have binge eating disorder most likely. Has anyone delayed/decided against getting pregnant due to their obesity? Or been obese but everything was fine?

I'm obese and 9 weeks pregnant today, I have had no luck losing weight either but I don't binge eat. I want to live a long and healthy life so I'll definitely put a lot of effort into it after baby is born and I've healed but for now I'm going easy on myself.

I have a BMI of 35, I had a little extra monitoring in my first pregnancy and had GD but otherwise weight wasn't mentioned at all and everything went fine. I've still got a BMI of 35 and just found out I'm pregnant again. I'm 42 so I think that's more of an issue for the Dr's than being overweight!

Congratulations @Cheetocat sounds like you have a balanced view of this. Definitely would also not restrict in pregnancy. I wish I could be less anxious.

Congratulations @MariaDingbat all the best!

I suppose it’s not the end of the world to have GD - I’m defo catastrophising.

Perhaps it could help you to reframe the way you are looking at things, so instead of focusing solely on your weight, focus on your health.

So you could think 'Am I eating a nice variety of vegetables, getting plenty of calcium, Omega 3 and folic acid?' Then you know you are getting yourself in a great place to provide all the nutrition to support a healthy growing baby.

I'm also obese and in the early stages of pregnancy. I do have worries, but to be honest I think most people are worried in their first trimester for various reasons.

@RonWeasleysBackfiringWand it sounds like we have a similar problem. My meals are really good but then I'll eat a family sized bag of crisps and half a pack of biscuits. I've seen a counsellor but it's a lifelong issue and hard to break.

I did intend to be healthier before trying for a baby but life didn't go that way, we've all lost a chunk of time to the pandemic and all I did was gain weight during it. The time to start a family was right for myself and my husband, and I thought my weight might slow down conception so we got trying, and have been very lucky.

One thing I will say is that I've cut out a lot of junk food since I found out I was pregnant. I had no willpower for myself, but I do for this little thing I'm growing. I want to do everything right for them, so while I'm still eating a good amount (around 2,500 calories a day) it's all tracked and less of it is junk.

I will say that between morning sickness, taking food intolerances seriously and the GD diet, I only gained 8lbs throughout pregnancy and a week after I gave birth I was 2 1/2 stone lighter than before I was pregnant.

I was obese and ended up lighter at the end of pregnancy somehow. Baby and pregnancy absolutely fine, no issues. My blood pressure was actually the best it had been 🤷‍♀️

I agree with the PP too, I found that I made better food decisions when it wasn't just me being impacted by it. I made sure to eat lots of fruit and veg, less processed foods, less chemical crap and nothing I was intolerant or allergic to. I'm doing the same again now without even thinking about it much.

I have a healthy 3 month old after a generally great pregnancy. I had extra monitoring throughout as being overweight makes means you are higher risk for certain things like pre-eclampsia and blood clots which meant certain preventative medication was prescribed such as blood thinner injections.
I think it can be scary as it isn't really talked about but we PP's have said, focus on being as healthy as possible rather than weight loss.

I was obese in two of my pregnancies (albeit just, BMI 31 and 33).
Absolutely fine & no health issues whatsoever, normal deliveries no issues.
Good luck

Obesity (BMI over 30) doubles the risk of stillbirth, and slightly increases the risk of early miscarriage, so it is sensible to address your weight before trying to conceive.
The mechanism is not fully established, but is possibly related to insulin resistance and poor placental function.
Obese mothers receive extra monitoring in pregnancy, and checks for gestational diabetes, to try to mitigate the damage.
Having said that, the majority of obese mothers do “get away with it” in terms of achieving a live birth, but there is evidence accumulating now that a fetus grown in a “diabetogenic environment” in utero is at higher risk of poor health in adult life.
The take home message is really to get your weight down to a healthy level as far in advance of pregnancy as possible, and keep it there.

Out of interest, what do they class as obese in terms of needing closer monitoring? (Sorry if I'm hijacking your thread a bit)

Obese in both pregnancies and 2 healthy boys. No GD, no high blood pressure, no PGP either.

I put very little weight on on both pregnancies and was back in prepregnancy jeans only a few weeks later.

Best of luck!

My BMI was 41 when I got pregnant. Got it down to 38 by my 12 week scan thanks to a combination of morning sickness and being very thoughtful about what I did manage to eat (mostly avoiding sugar). Had an incredibly easy pregnancy with really no issues (bar morning sickness) and despite 3 GD tests (I had a massive baby!), I was never anywhere near developing GD. Went to 41+5 with a 10lbs 13oz baby and was never even the slightest bit uncomfortable, was able to walk good distances throughout and felt fantastic. Was 2 stone lighter a week after giving birth than I had been before I got pregnant. I did have to have a C-Section but that was because my baby was huge, nothing to do with me - she literally couldn't fit through my pelvis!

Don't assume just because you're overweight you can't have a healthy pregnancy. I watched what I ate, did pregnancy yoga and got some advice from a physio on keeping my core strong.

One of the happiest times of my life. The less said about the almost 4 stone I put on in the 2 years after she was born (thanks PND), the better... thankfully I've managed to lose it all again now!

Thanks for all the replies so far. Very reassuring. I am a health care professional myself but not anything to do with obstetrics. I really beat myself up about being obese!

You're at a higher risk of various issues with a high BMI, but still more likely to have a healthy pregnancy than not. It's worth digging into the figures to find your absolute risk of things, rather than just the scary 'twice as likely' type headlines where it's actually e.g. 1.2% instead of a 0.6% risk.

I am currently 35 weeks pregnant with a BMI of 45. My pregnancy wasn't planned and if I'd been planning I probably would have lost weight first to reduce my risks.

My glucose tolerance test (for gestational diabetes) came back with perfect numbers, blood pressure is 120/80 every time, I've kept fairly active throughout, and baby is measuring well. So I'm a good example of the various higher risks not actually happening.

No one knows which way things will go before they get pregnant (at any BMI), so my view is pretty much that it's a good idea to reduce your risks where you can, but it's not the end of the world if you don't. Risks also increase with age, so there's a balance to be struck.

OP if the weight isn't coming off, my suggestion would be to think about improving your health in other ways, e.g. getting exercise, eating more fruit, veg and protein, reducing salt, building strength, working on your mental health, etc. Then even if your weight is the same you will be healthier at that weight. Also start a higher dose of folic acid before conception.

It’s interesting how many of you lost weight! Not a reason to have a baby obvs. but I wouldn’t have guessed that happened.

Thanks for the thoughts @SweetPeaGirl I love the idea of adding more fruit and veg even if weight doesn’t go down. Going to take that on board. And congratulations to you 🎊😁

Oh I did it deliberately, I wanted my BMI to be below 40 when I was booked in so I had the choice of using the mother and baby unit and having a water birth (in the end I couldn't because I needed a section). But I mostly did that by eating protein first, veg second, and carbs as a last resort!

Hey! So I'm nearly 35 weeks along with a BMI of 35. I've made a conscious effort to eat better when I found out I was expecting - it definitely helped that I was (still am!) craving water and fruit, and suffered from indigestion so my portion sizes were smaller. I didn't put on any weight between 12 weeks and 24 weeks.

I am lucky in that I've had a very easy pregnancy; I've not had any GD and though my blood pressure has been consistently on the high side of normal, the midwives haven't had any cause for concern.

Sorry I'm not much help OP but I have similar worries to you. According to my BMI I am exactly 30 and obese. I'm a UK size 14 so this was a shock to me - I must be in denial because, as much as I know I'm overweight, I didn't think I looked obese.
I'm currently 9wks pregnant and SO worried about my weight. I have been so inactive since week 6 as my main symptom is fatigue - it's knocked me for 6! For this reason I think I have gained weight already as I've had no sickness/aversions, so eating normally and exercising less.

Sorry for hijacking but, to PPs, do food aversions and sickness typically come in the first 12weeks? And does the fatigue get any better so I can start exercising again 😬

I'm a size 18/20 and bmi is 38. I fell pregnant accidentally in the middle of losing weight and although over the moon I was mortified at the thought of being an overweight mum to be! In fact a day after finding out I had a meltdown about it and felt disgusted with myself for getting pregnant when so overweight.

When I booked for my pregnancy, I was given a lot of risk factors such as pre eclampsia, blood clots, higher risk of gestational diabetes. The general outlook was really negative and that I would be higher risk purely because of my bmi (I have no underlying health issues). I was told I'd have to birth on labour ward and not birth centre, would likely need additional monitoring and assisted birth etc. I would also have consultant led care rather than Midwife led. I understand that the Midwife booking my pregnancy was just doing her job.

I was honestly I was so dissapointed in myself to put myself and baby at so much risk.

But I am now 30 weeks and have had a great pregnancy so far. I take daily prescribed aspirin, higher dose of folic acid and vitamin D, plus booked growth scans for 32,36,39 weeks. I see my Midwife every 3 weeks for blood pressure and urine checks (all precautionary based on higher bmi guidance). I've had one telephone appointment with a consultant who was not concerned at all and will see a consultant in clinic after my growth scans which is standard practice for anyone who has a growth scan regardless of bmi.
I have been tested for gestational diabetes which I was led to believe was a given with being obese and not got it.

I'm now in my 3rd trimester and have realised that it really does depend on individual circumstances, some lower risk friends who are pregnant within normal bmi range have actually had a worse pregnancy and ended up higher risk for other reasons outside of their control. They've had a rotten journey compared to mine. So I feel very lucky.

Obviously the hospital have to give you all the risk factors relating to your individual health. But I was literally led to believe because of my bmi and weight that I was in for the worst pregnancy experience ever, and this has not been the case.

I still have labour to go yet... But I'm much more positive than where I started all those months ago!

I've now been told I have the option of birthing in the birth centre too as my only risk factor is bmi.

So if I could give one piece of advice it would be to try enjoy your pregnancy, yes higher bmi and being obese comes with a set of risk factors but really none of us have any control over how our pregnancy will pan out.

Also I found I lost weight in my 1st trimester and have eaten well and gained minimal weight throughout my pregnancy.

Good luck with your journey x

I've had two pregnancies. The first time my BMI at booking in was 26 and fine second time it was 31. (Lockdown and baby weight did a number on me )

Anyway, the only difference has been that this time I have to have a higher dose of folic acid, which was free because my GP prescribed it, and also I had to have a GD test. I don't have GD. I've had blood pressure and urine tests every midwife appointment but that is the same for everyone and all my results have been normal.

My due date was yesterday and everything's been completely straightforward so far. At my 34 weeks appointment I'd put on 7kg since booking in and midwife was not concerned at all. I'm expecting to have this baby on the MLU as in my trust they accept you if your BMI is anywhere up to 40 and you're otherwise low risk.

So - congratulations! It could well all be fine and you should be looked after exactly the same as anyone with any BMI.