Mothers Who Lose Weight Before Further Pregnancy ‘Reduce Risks’

Institute also warns against trying to lose weight too quickly after pregnancy. Photograph: Katie Collins/PA

Women are to be told they should aim to lose all their baby weight before getting pregnant again or face an increased risk of complications, under official health guidance published today.

The advice on dealing with problems of excess weight and obesity before, during and after pregnancy warns mothers-to-be it is a myth they should “eat for two” or drink full-fat milk, with such actions likely to make them put on unnecessary weight they might struggle to shift.

A woman’s energy needs only increase in the last three months of pregnancy, the National Institute for Clinical Excellence (Nice) says, and then only by around 200 calories a day – less than an average chocolate bar.

Research shows that retaining even one or two pounds after giving birth can make problems more likely in a subsequent pregnancy, experts said, with women who have several children facing a “slippery slope” if they continue to gain weight each time.

But Nice also warns against trying to lose weight too quickly, and says media stories about celebrity claims of “unrealistic and rapid weight loss” after pregnancy were unhelpful. “This may create additional pressure on women to lose weight inappropriately at an already stressful time,” its guidance says. Pregnant women should also be told that moderate physical activity, like cycling to work, will not harm them or their unborn children.

The document, which outlines the importance of achieving a healthy weight and body mass index (BMI) before getting pregnant, is published amid growing evidence of the risks female obesity poses for mother and baby. These include miscarriages, pre-eclampsia, diabetes, and maternal death. Babies born to obese women face a higher risk of death, stillbirth, congenital abnormality, shoulder dystocia – where a baby’s shoulder becomes stuck during birth – and an increased likelihood of childhood obesity.

Statistics suggest 15%-20% of women getting pregnant are overweight or obese, with the number in the obese category estimated to have doubled over the last 20 years. Lucilla Poston, director of maternal and foetal research at King’s College London, said health professionals were dealing with “an epidemic of obesity” among pregnant women that put them at increased risk of “almost every complication in the book”.

She added that implementing the guidance would lead to large cost savings in the medium- to long-term.

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