Obesity and Pregnancy

Healthy Pregnancy: The Relationship of Obesity and Pregnancy

 Obesity and Pregnancy

Congrats- you’re expecting! Perhaps you’ve tried for many months- or even years- and it’s finally happened. Then again, maybe you really weren’t even trying.

Either way- you have a bouncing baby on the way and you want to do everything you can to ensure that you have a healthy baby.

However, one thing you’re already struggling with is your weight- and you know you’re only going to gain more.

Did you know that obesity during your pregnancy not only has a major impact on your own health- but the health of your baby as well?

Here, we will discuss some of the potential complications that can result, recommendations for healthy weight gain, and some things you can do to ensure a healthy pregnancy.

What exactly is considered obese?

The definition of obesity is an excess amount of body fat. The body mass index, known as BMI, is a formula based upon height and weight.

BMI is typically used to determine whether or not an individual is overweight or obese. Following is some BMI information:

If your BMI is below 18.5, you are considered to be underweight. A BMI of between 18.5 and 24.9 is considered to be normal/average weight.

If your BMI is between 25 and 29.9, you are considered to be overweight. If your BMI is 30 or higher, you are considered to be obese and if your BMI is 40 or higher, you are considered to be extremely obese.

Your BMI number is calculated by the following formula: weight in pounds divided by height in inches squared multiplied by 703.

What are some causes and risk factors for becoming obese?

Generally, obesity is the result of a combination of causes and risk factors including the following:

Genetics: the truth is that genes do have an effect on the amount of fat your body stores and where it distributes that fat. In addition, genetics have an influence on the way and the efficiency with which your body converts food into energy as well as the way your body burns calories when you are exercising.

Family lifestyle: generally, obesity runs in families- if one (or both) of your parents were/are obese, your chances of being obese are much higher. This isn’t just due to the genetic factor- but also due to the fact that families tend to share both activity and eating habits.

Inactivity: you probably are already aware- but if you’re not physically active, you’re not going to be burning as many calories as someone who is active.

When you have a sedentary lifestyle, you’re going to consume more calories each day than you are burning- which will lead to obesity.

In addition, medical issues such as arthritis lead to a decrease in the level of activity- which can lead to increased weight gain.

Unhealthy diet: when you make poor choices in regards to what you’re eating- choosing foods that are high in calories as opposed to healthy foods such as fruits and veggies- you are more likely to gain weight and become obese.

Medical issues: in some cases, obesity is due to a medical issue such as Cushing’s syndrome, Prader-Willi syndrome, or other possible conditions.

Additionally, as mentioned earlier, arthritis can also cause weight gain- due to the decreased levels of physical activity.

Specific medications: there are some medications that can cause weight gain and lead to obesity if you’re not paying attention and compensating by consuming a healthy diet or getting adequate exercise.

These medications include the following: medications for controlling diabetes, antidepressants, antipsychotics, anti-seizure medications, beta-blockers, and steroids.

Social/economic issues: there is some research that supports the thought that social and/or economic factors have an influence on obesity.

After all, it is very difficult to avoid becoming obese if you don’t have a safe area that you can exercise.

Also, if you haven’t been taught how to cook healthy meals or you don’t have the money to purchase healthy foods, you’re more likely to become obese.

Finally, if you’re spending time with unhealthy or obese friends and/or relatives you’re more likely to gain weight.

Age: while it’s true that you can become obese at any age- even children can be obese- your chances of becoming obese do increase with age. After all, your body goes through many hormonal changes and in some cases can lead to lower activity levels.

Since you’re not as active, you have less muscle mass- which means that your metabolism decreases. If you’re not active, your body doesn’t need as many calories- so if you don’t change your eating habits, you may find that you have a harder time keeping off extra weight.

You must make a conscious effort to become more active (or maintain your activity levels) and pay more attention to what you’re eating.

Pregnancy: it is true that when you become pregnant, you’re going to gain weight- that’s a given. However, many women do find that since they’re “eating for two” they eat more- which leads to more weight gain. Then, after they have the baby, they have a hard time losing weight.

Quitting smoking: smoking is a terrible habit- and sometimes when an individual quits smoking, they gain weight.

In some cases, this weight gain leads to the condition of obesity. However, even though your risk of becoming obese is increased if you quit smoking, it is still better for you to quit than to keep smoking.

Lack of sleep/poor quality of sleep: if you’re not getting adequate sleep- or you’re getting too much sleep- you will have some changes in the hormones that control your appetite.

You will have an increased appetite as well as cravings for foods that are high in carbohydrates and calories. This can lead to weight gain- which can eventually lead to obesity.

Of course, even if you do have one or more of the above risk factors, it doesn’t automatically mean that you will become obese. You can make a concerted effort to get adequate exercise, pay close attention to what you’re eating/make healthy dietary choices, and even make some changes in your behavior.

 Obesity and Pregnancy

Is it possible for obesity to affect an individual’s ability to become pregnant?

Yes, when a woman is obese, it is possible that her body will be unable to ovulate normally. In addition, obesity can have a significant impact on IVF or in-vitro fertilization. As a woman’s body mass index increases, so do the risk of being unable to conceive- through IVF or otherwise.

What are some of the effects of obesity on pregnancy?

Obesity during pregnancy- whether you were obese before you became pregnant or become obese as your pregnancy progresses- can increase the risk of the following complications:

Gestational diabetes: Women who have a normal weight are at a lower risk for developing a condition known as gestational diabetes. However, if you are obese while you are pregnant, you are much more likely to develop this condition. In some cases, diabetes will clear up after you give birth. On the other hand, the condition may continue- and you may pass it on to your baby.

Preeclampsia: obese women who are pregnant are at a much greater risk for developing a condition known as preeclampsia. This is a condition that is characterized by high blood pressure and signs of damaged kidneys or other vital organ systems.

Infections: women who are obese while they are pregnant are at a much greater risk for developing urinary tract infections, or UTIs. In addition, obesity while pregnant will increase your risk for developing a postpartum infection- whether you have a C-section or give birth vaginally.

Overdue pregnancy: women who are obese are at a much greater risk of carrying their baby beyond their expected due date. Women of normal weight are much more likely to deliver on time- or even just a little early.

Problems during labor: women who are obese while pregnant are at a much greater risk for having to be induced than women who are of normal weight. In addition, obesity can have an effect on pain medication- keeping it from working properly.

C-Section: if you are obese, you are much more likely to be required to have an emergency or elective C-section.

In addition, obesity will increase your risk of developing complications such as infections after having a C-section. Women who are obese before or during their pregnancy are much less likely to be able to have a successful VBAC or vaginal delivery after C-section.

Loss of pregnancy: women who are obese while pregnant are at a much greater risk of experiencing a stillbirth or miscarriage.

Can obesity have an effect on the baby?

In addition to the obese mom during pregnancy, you can cause some significant health issues for your baby including the following:

Macrosomia: moms who are obese while pregnant are at a much greater risk for having a baby who is much larger than average, known as macrosomia.

These babies tend to have more body fat than other babies. The research does show that the higher the birth weight of a baby, the higher the risk of them developing childhood obesity.

Chronic conditions: if you are obese while you are pregnant, your baby is at an increased risk of developing chronic health conditions such as diabetes or heart disease when they become adults.

Birth defects: some research has suggested that being obese while pregnant can increase the risk of giving birth to a baby with birth defects.

How much weight is healthy to gain during pregnancy?

When you are trying to determine a healthy weight to gain while pregnant, you should be aware that your pre-pregnancy BMI and weight, as well as your health and the health of your baby, will determine the amount of weight that is healthy for you to gain during your pregnancy.

You’ll want to talk with your physician or midwife to figure out what is best for you and to keep tabs on your weight gain throughout your pregnancy.

Of course, you can use some of the following general guidelines for weight gain during pregnancy and obesity:

  • Single pregnancy: if you are already obese and you’re pregnant with one baby, it is recommended that you gain 11 to 20 pounds.
  • Multiple pregnancies: if you are already obese and you’re carrying multiples, it is recommended that you gain 25 to 42 pounds.

Keep in mind that there is some research that maintains that women who are already obese before becoming pregnant can safely gain less weight than the general guidelines suggest.

Instead of trying to gain or lose a specific amount of weight during your pregnancy, your physician or midwife may just encourage you to avoid gaining too much weight during your pregnancy.

Am I going to need any specialized care while I am pregnant?

If you’re already obese, your physician or midwife will be very closely monitoring your pregnancy. Of course, depending upon your personal circumstances, your healthcare team will be likely to recommend one or more of the following:

Gestational diabetes testing: typically, for women who are at average or an increased risk of developing gestational diabetes, a screening test that is known as the glucose challenge test will be performed sometime between 24 and 28 weeks.

If you’re already obese, chances are that your physician or midwife will suggest that this test be done much earlier- even as early as your very first prenatal visit.

Even if the test comes back normal at this time, it will likely be done again between 24 and 28 weeks. On the other hand, if the results come back abnormal, you will be given further testing. Then, your physician or midwife will explain to you how to monitor and control your blood sugar levels.

Delayed ultrasound: typically, a fetal ultrasound will be performed between 18 and 20 weeks to evaluate the baby’s development and growth.

However, in obese moms, this will be delayed because the ultrasound waves do not penetrate abdominal fat very easily and therefore, can cause some issues with the ultrasound. If the ultrasound is done later, between 20 to 22 weeks, it is much more likely to be detailed.

Fetal echocardiography: if you are obese while pregnant, your physician or midwife is likely to suggest that a fetal echocardiogram be performed between 22 to 24 weeks.

This will give a detailed picture of your baby’s heart. The results of this will tell you whether or not your baby has a congenital heart defect.

Frequent prenatal visits: as you progress into your pregnancy, if you are obese, your physician or midwife is much more likely to recommend that you have prenatal visits more frequently than a mom who is of normal weight.

These will closely monitor both your health and the health of your baby. In addition, frequent fetal ultrasounds will likely be recommended to keep a close eye on your baby’s growth and development and to build a plan for your delivery.

What can be done to ensure that an obese mom has a healthy pregnancy?

While it’s true that obesity before or during pregnancy can have an impact on your ability to have a healthy pregnancy, there are some things that you can do to increase your health as well as the health of your baby. These steps include:

Have a preconception appointment: if you are considering becoming pregnant and you are already obese, you should definitely discuss your plans with your physician.

It may be recommended for you to take a prenatal vitamin to become healthier or even to visit other physicians such as an obesity specialist or a registered dietician who can help you to get to a healthy weight before you become pregnant.

Ensure regular prenatal care visits: having regularly scheduled prenatal visits will help your physician to monitor your health and the health of your developing baby.

You should speak with your physician about any medical conditions present such as high blood pressure, sleep apnea, or diabetes and find out some ways that you can manage them while pregnant.

Consume a healthy diet: you should speak with your physician or even a registered dietician to ensure that you are consuming a healthy diet and not gaining too much weight.

You should keep in mind that when you are pregnant, you will need more iron, calcium, folic acid, and other critical nutrients.

A daily prenatal vitamin will fill in any gaps in your diet. If you do have special nutritional needs due to a specific health condition, you’ll want to speak with your physician.

Maintain/Become physically active: you should speak with your physician or midwife about an exercise program that is safe for you to continue or begin during your pregnancy.

Avoid risky substances: there are some things that you should avoid while pregnant, such as smoking, alcohol, and illicit drugs. If you have questions about specific medications or supplements that you’ve been taking, you should speak with your physician about them.

When you are obese before you become pregnant or become obese while you are pregnant, you will increase your risk of developing health complications for both you and your baby.

In order to ease your fears, you should discuss this with your physician or midwife. They will be able to keep you from gaining too much weight, properly manage your medical conditions, and keep an eye on your baby to ensure proper growth and development.






  1. i didn’t know obese moms get different care during their pregnancies, like the delayed ultrasound! of all the pregnancy stuff I’ve ever read, this never really came up…but I guess it obviously makes sense!

  2. I have also seen that obesity isn’t the only weight problem that can affect pregnancy. I’ve actually seen that underweight women have problems too. There’s a British TV show called Supersize vs. Superskinny. In the show, they match an obese person with a seriously overweight person. The goal is that they help each other lose/gain weight. They have plenty of guidance from a doctor and with the younger women on the programme one of the main concerns is always pregnancy. Many of the underweight girls’ menstrual cycles have actually stopped. They’re basically infertile.

  3. I am actually in that category… I have been overweight since I am 6 and now medically considered as “obese”… though I am healthy and living it very well it is clear that it is one of the reason why I cannot conceive… so since I am trying to work on that… it is a really hard work
    but when you see the consequences it can have on both you and the baby, It’s worth doing it
    this article is surely a good reminder, thank you !

  4. Wow this is a lot of information in one post. I had no idea about majority of this stuff but the issue that being overweight can have an affect with the drugs you are giving is a little scary. I want my drugs to work properly during this time. 🙂

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