No Easy Path To Dropping Pounds After Pregnancy

sharma-obesity-pregnancy5Gaining excessive weight during pregnancy and retaining much of it after delivery is ones of the most common drivers of adult obesity in women.

Emerging evidence supports the notion that both may well be detrimental to the health of mothers (and their kids).

Unfortunately, it appears that behavioural intervention during pregnancy to reduce long-term weight retention is a lot more challenging that one may expect.

This is the rather disappointing outcome of a randomised controlled trial by Suzanne Phelan and colleagues, published in the American Journal of Clinical Nutrition.

The trial included 400 US Women, half of who were overweight or obese, randomly assigned to a behavioural intervention or control group beginning around the 13th week into their pregnancy.

The intervention (Fit for Delivery) consisted of one face-to-face visit with an interventionist at the onset of treatment, the provision of body-weight scales, food records, and pedometers to promote adherence to daily self-monitoring, weekly postcards prompting healthy eating and exercise habits, personalized graphs of their weight gain with feedback, and supportive phone calls from the dietitian during the intervention. This intervention continued till delivery.

Four out of five of the participants completed the 12-mo assessment.

Overall the intervention did not increase the participants’ chances of achieving their prepregnancy weights. Even the completer analysis showed non-significant trends at best – this despite women in the intervention group reporting higher levels of dietary restraint and more frequent self-monitoring of body weight.

Thus, this level if intervention, which far exceeds usual care during pregnancy for most women, does not appear to effectively reduce post-pregnancy weight retention.

Incidentally, the only predictors of excessive weight retention were pre-pregnancy BMI and excessive gestational weight gain. Breastfeeding, age, parity, and delivery weeks were not.

Thus, although excessive pregnancy weight gain and post-pregnancy weight retention are common problems with significant negative health impacts on both mother and child, it will apparently take far more than an additional visit with a dietitian and exercise counsellor or postcards and telephone reminders to impact body weight.

I wonder if anyone else is not all too surprised by these findings?

Edmonton, AB

ResearchBlogging.orgPhelan S, Phipps MG, Abrams B, Darroch F, Grantham K, Schaffner A, & Wing RR (2014). Does behavioral intervention in pregnancy reduce postpartum weight retention? Twelve-month outcomes of the Fit for Delivery randomized trial. The American journal of clinical nutrition, 99 (2), 302-11 PMID: 24284438