Healthy Diet To Lose Weight While Pregnant

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You are eating for two and that’s fact. But you also need a healthy diet to lose weight while pregnant so listen up! It’s tough because your body is changing and you crave different foods but only certain things can make your baby healthy. In this article I will teach you what foods to eat, what foods to avoid and why. First of all, lets start with the basics. What are the basic foods you should have?

Losing Weight While Pregnant

In early pregnancy, the baby is still quite tiny and only has minimal caloric and nutritional needs. So, a bit of unintentional weight loss during the first trimester (usually related to morning sickness) won’t negatively impact your baby’s development, as long as it isn’t substantial or prolonged.

Keep in mind, too, that what is considered healthy weight gain in the first trimester is typically only a few pounds depending on your pre-pregnancy weight—usually just 2 to 4 pounds.

If you lose a couple of pounds, rather than gain, in early pregnancy, the net loss will only be several pounds. These pounds will usually be quickly recouped when nausea fades and appetite returns by the second trimester.

Body Mass Index (BMI) is a dated, biased measure that doesn’t account for several factors, such as body composition, ethnicity, race, gender, and age.

Despite being a flawed measure, BMI is widely used today in the medical community because it is an inexpensive and quick method for analyzing potential health status and outcomes.

Why Weight Gain Matters

After the first trimester, however, gradual weight gain becomes vital for the health of the baby as well as for building up essential fat stores to prepare a women’s body for supporting a growing baby, labor, delivery, and breastfeeding.

It’s typically not wise to follow a heavily restrictive diet or to drastically cut calories or food groups while expecting. Your growing baby’s optimal development will increasingly rely on you consuming adequate calories and nutrients. However, to some extent, your baby is able to use your body’s fat stores if needed.

Pregnancy can trigger morning sickness as well as encourage women to shift to healthier eating styles, both of which can result in early pregnancy weight loss. In some cases, a small amount of doctor-supervised weight loss may also be recommended for pregnant women who have a body mass index (BMI) of 30 or higher.

BMI Explained

Body mass index is a guideline based on your height and weight and is an estimate of your body fat. Be aware that healthy weights are more than simply your BMI calculation and many women (over 50%) fall outside of the “normal” category. Consult with your doctor to determine if your weight is healthy for you.

Morning Sickness

Morning sickness is very common, impacting about 70% to 80% of pregnant women in the first trimester. Caused by the huge hormonal shifts of pregnancy, morning sickness symptoms include:

  • Fatigue
  • Nausea
  • Reduction in appetite
  • Sensitivity to smells
  • Vomiting

So, many pregnant women have trouble keeping food down, which is why some weight loss may occur. But as long as you are still eating a little and not losing more than a few pounds, mild to moderate or occasional morning sickness is not something to be concerned about. Usually, these symptoms improve by week 14 and weight gain will commence.

Hyperemesis Gravidarum

However, sometimes morning sickness can escalate to a more serious extreme morning sickness known as hyperemesis gravidarum (HG). In this condition, women experience magnified symptoms and more substantial weight loss.

Dr. Chris Han, a physician at the Center for Fetal Medicine and Women’s Ultrasound, says, “A patient is felt to have HG if she has persistent vomiting accompanied by weight loss exceeding 5% of the pre-pregnancy body weight, along with evidence of ketones in their urine.” For example, a woman with HG who starts out her pregnancy weighing 140 pounds would lose about 7 pounds or more.

Research shows that about 36,000 women are hospitalized each year in the United States with cases of HG.1 The actual number of women with the condition might be much higher since women may be treated at home or as outpatients through their health care provider.

Hyperemesis gravidarum is characterized by severe nausea and vomiting, which can result in severe dehydration and inability to keep food down. As a result, there is the potential to lose weight if you experience this condition.

HG usually appears in weeks 4 to 6 of pregnancy and can peak around 9 to 13 weeks. Most women receive relief around weeks 14 to 20, however, some women require care throughout their entire pregnancy. Hyperemesis can be treated outside the hospital, but in severe cases, hospitalization may be necessary.

Treatment Options

There is no way to prevent hyperemesis gravidarum, but there are many ways to treat it. Medical interventions may include medications, as well as infusions of intravenous fluids to replace lost fluid and electrolytes.

In extreme cases, nutritional support is necessary and may require a surgical procedure. Additionally, some alternative therapies may be recommended. Some examples of these are bed rest, herbal treatments, and acupressure.

Other Causes of Weight Loss

If morning sickness is not to blame, unintentional weight loss during pregnancy, especially sudden weight loss, is a concern and should be evaluated by a medical doctor as soon as possible. Likewise, weight loss due to changes in diet, eating disorders, food insecurity, and intentional dieting are not safe and should be discussed with your care provider. Some other potential causes of weight loss during pregnancy include:

  • Autoimmune disorders
  • Cancers
  • Eating disorders
  • Endocrine imbalance
  • Gastrointestinal diseases
  • Infections
  • Neurologic abnormalities
  • Psychiatric disorders
  • Substance use
  • Uncontrolled overactive thyroid
  • Undiagnosed diabetes
  • Other chronic diseases

“The most important intervention for a woman who is losing weight in pregnancy is to identify and treat the underlying reason for the inadequate weight gain,” says Dr. Han.

Can I lose weight while pregnant?

No matter how much you weigh, it’s not safe to lose weight while pregnant. (The one exception to this in the early weeks of pregnancy – see the reasons why below.)

The effect of a mom’s weight gain or loss on her baby during pregnancy is a complicated issue that experts continue to study, but we know that losing weight during pregnancy isn’t compatible with growing a healthy baby. And if you’re losing weight, you may not be getting all the calories and nutrients you need for a healthy pregnancy.

While being overweight or obese during pregnancy increases your risk for some pregnancy complications, losing weight during pregnancy puts you at risk of having a baby who is too small (small for gestational age, or SGA) and for preterm birth.

What if I lose weight in early pregnancy?

It can be normal to lose weight in early pregnancy, due to:

  • Morning sickness. In the first trimester, it’s common to lose weight as the result of morning sickness. The nausea can diminish your appetite, and the vomiting can cause you to miss out on calories. Don’t worry, your baby will get all the necessary calories and nutrients they need at this point.
  • Fat reserves. Overweight women have an extra reserve of calories in stored fat, so as your baby grows, it’s not harmful to maintain or even lose a little weight at first.
  • Improved lifestyle. You might lose weight early on if you’ve started exercising or eating healthier foods when you became pregnant.

In most cases, this weight loss isn’t dangerous. If you’re losing a lot of weight, though, or if you think you may be suffering from hyperemesis gravidarum (severe morning sickness), tell your provider right away.

How much weight to gain if you’re pregnant and overweight or obese

If you started off your pregnancy carrying too much weight for your height, you’re not alone. More than half of pregnant women are overweight or obese.

You’re considered overweight if your pre-pregnancy body mass index (BMI) is between 25 and 29.9. (Your BMI reflects the relationship between your height and weight, and is an estimate of body fat.) You’re considered obese if your BMI is 30 or greater.

Not sure what your BMI is? Try this BMI calculator.

How much to gain during pregnancy depends on your BMI:

  • If your BMI is 25 to 29.9: It’s recommended that you gain between 15 and 25 pounds by the end of your pregnancy, or approximately 2 to 3 pounds per month in your second and third trimesters.
  • If your BMI is 30 or higher: You’re advised to gain 11 to 20 pounds during pregnancy.

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For guidance, try our pregnancy weight gain calculator and learn more about pregnancy weight gain.

Though it’s not safe to lose weight during pregnancy, if you’re overweight or obese during pregnancy you may be able to safely gain less than the recommended amount – with your healthcare provider’s guidance and monitoring.

Pregnancy weight gain recommendations are provided by the Institutes of Medicine (IOM), and there’s been some controversy about the IOM amounts stated for obese women. One issue is that the IOM provided one recommendation for all obese women (those with a BMI of 30 or higher) rather than different numbers for different categories of obesity.

According to some researchers, if you’re overweight or obese, it may be safe (and advantageous) for you to gain less than IOM guidelines recommend. Some studies show that overweight or obese women who gain only 6 to 14 pounds had similar or better neonatal outcomes than women who gained the recommended 15 to 20 pounds, for example.

If you’re overweight or obese, talk with your provider about your target weight gain during pregnancy. If you gain less weight than recommended, they’ll want to monitor you and your baby to be sure your pregnancy is progressing well and your baby is growing appropriately.

Can I diet to lose weight during pregnancy?

Pregnancy is definitely not the time to go on a weight-loss diet, no matter what weight you’re at. Restricting your food intake is potentially hazardous to you and your developing baby. You need enough calories and nutrients to support a healthy pregnancy and baby.

Also, steer clear of carbohydrate-restrictive diets such as keto and Atkins. Your growing baby needs the carbohydrates, and ongoing ketosis caused by these diets can harm a developing fetus.

During pregnancy, you can keep your weight gain within your target range by eating healthfully and exercising regularly. Do your best to:

  • Eat balanced meals and healthy snacks.
  • Stay hydrated by drinking an average of about ten 8-ounce cups of water each day.
  • Choose complex carbs – such as beans, fruits and vegetables, and whole grains – over simple carbohydrates such as white bread, white rice, and white pasta.
  • Monitor your weight with your healthcare provider to make sure you’re on track.

Why Losing Weight While Pregnant Is Generally Not Recommended

Risks of Losing Weight While Pregnant

  • Nutrient deficiencies
  • Developmental delays
  • Small fetus for gestational age
  • Increased fatigue

Women who contend with severe nausea or food aversions may unintentionally lose weight during the early months of pregnancy, and these conditions need to be shared with and managed by your health care provider. But purposely trying to lose weight by dieting while pregnant is not advised.

Eating enough during pregnancy ensures both mom and baby will get the nutrients required for overall health. Dieting, cutting calories, or restricting food groups can result in nutrient deficiencies that can affect the developing fetus.

A meta-analysis and systematic review were conducted to examine pregnancy outcomes in obese women with gestational weight loss.2 The study found that women who tried weight loss diets during pregnancy had had higher odds of delivering babies that were small for gestational age, and the researchers concluded that weight loss diets should not be recommended during pregnancy.

Dr. Julie Rhee is a reproductive endocrinologist and infertility specialist and Director of the Preimplantation Genetic Screening Program at Vios Fertility Institute in St. Louis. Rhee advises a healthy diet and exercise program once you get pregnant, and cautions against weight loss during pregnancy.

“Drastic weight loss would be discouraged in pregnancy, but a healthy diet consisting of exercise and portion control with well-balanced meals can be started during pregnancy.”

Considering Weight Pre-Pregnancy

If you are trying to conceive, your health care provider may talk to you about losing or gaining weight to promote fertility and reduce pregnancy complications.

While people of all different shapes and sizes can get pregnant, studies show that there is an increased risk of certain complications in people with obesity. These potential complications include a higher risk of preeclampsia, preterm birth, and macrosomia (where the fetus is larger than normal, which can cause injury during birth).

If you are hoping to get pregnant, talk to your health care provider about positive, sustainable lifestyle changes that can support a healthy weight and promote fertility.

Risks of Being Overweight During Pregnancy

According to the ACOG, obesity during pregnancy may put you at risk of several health problems, such as:

  • High blood pressure
  • Preeclampsia (a serious form of gestational high blood pressure)
  • Gestational diabetes
  • Obstructive sleep apnea (a condition where you stop breathing for short periods during sleep)

Your obstetrician will monitor your blood pressure and blood sugar levels during your pregnancy to watch for signs of high blood pressure or gestational diabetes. They may give you specific diet and exercise advice to mitigate these conditions and promote a healthy pregnancy and delivery.

Optimal Weight Gain Recommendations During Pregnancy

When you get pregnant, you will meet with an obstetrician to develop a care plan. During your first visit, you may discuss nutrition and physical activity. You may also discuss your weight since pregnancy weight gain guidelines are often related to your starting weight.

According to the Institute of Medicine (IOM), there are different weight gain recommendations for women of different weights (classified by body-mass index, or BMI). But these are controversial, as BMI is not a reliable indicator of health.

Body Mass Index (BMI) is a dated, biased measure that doesn’t account for several factors, such as body composition, ethnicity, race, gender, and age.

Despite being a flawed measure, BMI is widely used today in the medical community because it is an inexpensive and quick method for analyzing potential health status and outcomes.

Your health care provider may use these standardized IOM recommendations to guide your weight goals during pregnancy. Note that some doctors may not agree with these BMI-based guidelines, and may not follow them.4

Current BMIRecommended Weight Gain
(Entire Pregnancy)
Rate of Weight Gain (2nd and 3rd Trimesters)
Less than 18.528-40 pounds1 to 1.3 pounds per week
18.5 to 24.925-35 pounds0.8 to 1 pounds per week
25 to 29.915-25 pounds0.6 pounds per week
30 or more15-25 pounds0.5 pounds per week

People of all shapes, sizes, and weights can carry out a healthy pregnancy. The ACOG states that you can have a healthy pregnancy if you are obese, but recommends paying attention to diet, weight, and exercise, and getting regular prenatal care to monitor for complications.

Weight gain below the IOM recommendations among overweight pregnant women does not appear to have a negative effect on the health of the baby. One systematic review suggests that overweight women who gain 6–14 pounds have outcomes as healthy as overweight women who gained weight within the currently recommended guidelines.

For the overweight pregnant woman who is gaining less than the recommended amount but has an appropriately growing fetus, no evidence exists that encouraging increased weight gain to conform with the current IOM guidelines will improve maternal or fetal outcomes.

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