Worried about weight gain in pregnancy despite eating less

[hangonwhilstioverthinkthis]

I had a BMI of 30 at the start of pregnancy. I know that's high. I was working on it, had started to exercise more regularly about 6 weeks before discovering I was pregnant (unplanned) and eating healthier trying to finally lose the weight from previous pregnancies.

At my booking appointment the midwife sincerely stressed the importance of not gaining more than 5kilos as my BMI is in the obese category already. She said the majority of gain will be in the third trimester.

Few things to know

• a horrible first trimester means I barely ate so I lost a few kilos
• since then I've still been dizzy and nauseous a lot of the time which means gym routine has been affected as I now rarely drive. I swim once a week with a friend who drives and walk briskly for about 30 minutes a day on the school run (the kids scoot/cycle so it is quite a fast paced walk). I am also currently decorating the house two days a week so doing a lot of stairs and up and down from the floor painting and wallpapering, sawing, carrying etc most days. DH and I do a lunch walk the other three days and we tend to go out for a walk on weekends with the kids. Not as much exercise as I'd like, however if I overdo it I am genuinely falling over dizzy (have told GP and midwife who say it's a common pregnancy thing and it'll go away after birth, yay) or get sciatica pain. Delightful.
• when I need to go out (say to the shops if DH is away which he is quite a bit) I cycle. Though I have to stop often as I'm wobbly from the dizziness so not exactly fabulous cardio. Its not great, but trying to see the comedic side wherever I can. Gets you through doesn't it!
• nausea and dizziness are made far worse if I eat a big portion (ie a dinner plate) or anything too fatty or sugary. Have found it's best managed by having 2 side plate size meals a day and absolutely no sweet treats.
• also had hideous reflux up until recently so got used to eating my last meal of the day around 4pm so it didn't affect sleep
• drinking 3-4 pints of water a day (I used to have squash)
• my meals have consistently been a one egg omelette with 1/4 avocado, 4-5 baby tomatoes and a handful of spinach on a small slice of sourdough toast with a small glass of OJ, then around 3pm either some sort of overnight oats with a tablespoon or two of greek yogurt, spoon of mixed nuts and seeds, chopped fruit (maybe 1/3rd of a banana, 1/4 of an apple, a strawberry, smattering of blueberries or grapes depending on what we have), chia and flaxseed for fibre, 2-3 dried apricots for iron, and a tablespoon of oats or leftovers from the family dinner the night before (varies...but examples might be Bolognese but with minimal rice/pasta, casserole, fajitas). Tried to focus on maximising protein/veg/good fats and minimising (not eradicating) carbs.
• I still have a massive sweet tooth, but I know if I give in to it I'll feel ill so it's been very motivational not to do it. An apple sliced with a tablespoon of peanut butter has helped, or add some honey to the oats. Not daily though.

I'm about to enter the 3rd trimester and have gained 5kgs. I cant comprehend it. Have gone from eating 3 full portions a day plus snacks and treats to 2 smaller meals with minimal snacks and no treats and still gaining more weight than I 'should' be. Yes exercise is lower, but only if you compare it to the 6 weeks immediately before getting pregnant.

I'm really worried about what this means for me and the baby. I've never been so focused on food before. Waiting for someone to tell me it isn't healthy, which it doesn't feel like a positive mindset tbh but am doing it to be physically healthy! I'm bitterly disappointed that despite really trying I've gained 5kilos (or more like 7 when you consider I lost around 2 due to sickness) with an entire trimester to go.

People say you shouldn't be trying to lose weight whilst pregnant, I'm not aiming to lose, but I don't want to gain anymore. WWYD?

Ps sorry for the long post, I set out with the aim to be succinct but don't want to drip feed and then before I know it I've written an essay!

I think your midwife has overegged her weight gain advice. It sounds as though you are eating healthily. Try not to worry but let her know you are. She may be shocked to hear him much you’ve taken it to heart.

I weighed more than you did and everything was fine.

I think I’d be dizzy and miserable eating such a small amount of food. You mention other children, so not your first pregnancy? Weight gain in pregnancy is strange anyhow. Often it is lots of fluid which dissipates very quickly postpartum. Remember you’ll have increased blood volume, placenta, amniotic fluid, baby, breast tissue etc which all adds up. I gained 50% of my body weight during pregnancy but lost it all again, though I wouldn’t recommend doing that!

The dizziness might be from blood sugar dips if you’ve cut food out to that extent too.

Tbh I wouldn’t worry too much. As others have said, you are growing a baby so blood volume etc has gone up. You are exercising so getting fitter even if it doesn’t feel like it.

Try to relax a bit and enjoy the last trimester as you’ll stress yourself with worrying about weight which isn’t good for you.

Thanks for the very reassuring answers so far. I know with the previous pregnancies I felt hungrier in the last trimester so was feeling a bit apprehensive about that happening again and feeling like I dont have any wiggle room to add a third meal or increase portions in case that results in more weight gain. My aim for this second trimester was to only regain the weight I lost in the first o that I had some leeway for the third, but that evidently hasn't happened.

I will bring it up with the midwife. They haven't officially weighed me since the booking appointment, but she was really very serious about it being imperative I don't gain weight. I think her words were 'we'd expect no more than 5kilos by the end of the third trimester given all the additional fluid and weight of baby etc. So that's your max'.

My last baby weighed 4kilos at birth so I did expect to go over the 5, but not with 12 weeks to go 🙈

Tell the midwife to get knotted. I had a BMI over 40 by the end of both my pregnancies. I had 2 home water births with no complications then or in pregnancy. Obviously don't go crazy and eat everything in sight but eat so you feel nourished instead of dizzy from lack of food. That's not safe in pregnancy. Tbh your midwife needs some training as she could trigger someone who has or has had an eating disorder. She's there to offer advice not lay down the law.

Your midwife sounds like an idiot. You don’t need to go crazy during pregnancy with the overeating but it’s not a time to be restricting what you’re eating. The only thing that worked for my nausea during pregnancy was eating often! I’d guess the dizziness is partly a result of eating so little. At the end of the day, you can always lose the weight post-baby (easier said than done, I know) and you need to eat enough for pregnancy and what sounds like a relatively active lifestyle.

Hormones are hitting hard today, these answers are making me feel emotional! Honestly it's been taking over my brain for months. I expected people to be berating me, not being so kind and reassuring.

Thank you.

Your midwife is parroting some nhs guidance. Really bodies respond to hormones. Your body is responding to hormones. I was very thin at the lower end of healthy bmi when I first got pg. I gained 2.5 stone, as soon as I gave birth I lost 2 stone and then the first al 0.5 stone went when I stopped bf. I didn't do anything it was literally the hormones. Honestly don't stress about it it souds like you are eating healthy.

Had your midwife done any if the math? Her advice sounds absolutely bizarre...

A full term average baby will weigh about 4kg in itself, placenta .5kg and then all the fluid.

@BudgetBuster I really don't know. I have an appointment on Friday though so will bring it up. This thread has made me feel braver about mentioning it. You'd think it being my third time I'd be a pro at chatting with midwives by now, but I wasn't overweight for the last two. I'm also classed as geriatric so there was a lot to talk about.

The NHS website suggests 5-10kg is acceptable overall, with around half of that being in the third trimester. This feels more manageable. Would end up with a BMI of around 35, but as you say a fair whack of that will be baby/placenta/fluid/additional blood etc.

Never really paid much attention to BMI before. Preferred to concentrate on how fit I felt and how my clothes felt. Bleugh!

Your BMI would increase but BMI doesn't take into account you are literally 2 people!
A large chunk of the weight will drop immediately.

@BudgetBuster indeed, quite genuinely drop! So much easier to carry in a sling 😅 looking forward to meeting this little bean immensely!

Oh it’s such a shame you didn’t post this earlier, you definitely shouldn’t be feeling like you need to lose weight in pregnancy & the midwife has dealt with that terribly!!

if you’re eating healthily and exercising, you’re doing exactly the right thing. ❤️

Really unhelpful midwife. Carry on eating healthy, nourishing food so your body has what it needs to build a baby and try not to worry about your weight.

IIRC the UK guidelines are a bit less prescriptive than US guidelines, but in the US women with obesity at booking are advised to aim for round about 5-10kg weight gain in pregnancy. I think in the UK the usual advice is that 10-12kg is normal, but women with obesity should aim for less, but that dieting is not advised. It's becoming increasingly common to see women who've put on 25-30kg. BMI is a useful measurement at booking, but is not supposed to be calculated or acted upon when women are weighed later in pregnancy (there are some reasons that having an accurate weight at term is useful).

OP, if you're worried you could ask to see a consultant or to be referred to a dietician (perhaps one of the 'perks' of having ticked the obese box at booking is that it can make it easier to access extra support!). Excess weight gain definitely can cause problems, but I suspect they may be a bit more concerned that you're being restrictive if you're feeling unwell. It's possibly also worth thinking back to when they did your booking measurements - what were you wearing (is there any chance that taking your shoes off might have put your BMI below the threshold that triggers strong advice?). If you've been restricting your intake then it may be worth asking what your iron stores are like (when are your next set of bloods due?).