5 min readJun 23, 2023 04:55 PM IST
First published on: Jun 23, 2023 at 03:13 PM IST
Women gain extra kilograms during pregnancy but sometimes it’s a challenge to lose weight after delivery, causing health problems. But for someone like 31-year-old Sheeba Garg (name changed) who weighed 112 kg at the time of delivery and developed blood pressure as well as diabetes during her pregnancy, her acquired obesity posed a life threat. Apart from having difficulty during delivery, doctors had to put her on blood thinners to reduce the risk of thrombosis postpartum. She lost 10 kg immediately after delivery but weighed around 90 at the end of two months post-delivery. Now, the doctors have put her on a weight loss plan with medication for her underlying health issues.
Dr Sangeeta Rodeo, Consultant, Gynaecology and Obstetrics, at Fortis Hospital, Mumbai, has been helping women deal with their postpartum weight and explains the biological reasons why the body might want to hold on to the acquired fat.
What causes postpartum weight gain?
Postpartum, or the period after pregnancy, is often accompanied by weight gain for many new mothers. Since birthing requires a lot of energy and can be a draining process along with breastfeeding, the new mother tends to consume a lot of calories. She even eats extra out of the desire for reward-seeking as she deals with hormonal and emotional changes. That’s why losing weight becomes extremely difficult, especially with a lack of exercise. Undoubtedly, obesity during the postpartum period is one of the biggest public health challenges and requires a combined effort so that new mothers can tackle it effectively. Additionally, if the gestational weight of the women during pregnancy is high, the chances of postpartum weight retention are also on the higher side.
Many women today live in nuclear families, which can make infant care difficult and cumbersome. Many women lack the time, energy and motivation to manage or lose their post-pregnancy weight, especially when managing their baby and household chores. In such a scenario, they should seek help from dieticians and medical experts, but due to lack of time, they do not seek resources to understand which exercises and diet they should focus on for maximum weight loss. In some cases, they follow the advice of their elders and practise standard socio-cultural norms, which sometimes focus on high-calorie food consumption and lack of physical activity (not allowing postpartum women and infants to step outside their house). Further, if the woman has other conditions like postpartum thyroiditis, diabetes, depression or eating disorders, they can cause even more significant weight gain during this period.
When is the right time to start exercising?
Pre-conception body weight must be considered while fixing the target for weight gain during pregnancy. This will make losing weight easier. All postpartum women should be assessed for their body mass index or BMI at six weeks. If their BMI is more than 23 kg/m2 at six weeks, they should be encouraged to sign up for a weight management programme that involves lifestyle and medical management. In cases where women have had an uncomplicated delivery process, they must be encouraged to resume physical activity within four to six weeks, depending on their comfort level.
Women who have had emergency C-sections or complicated deliveries should only start exercising after they have been cleared by their medical team (which is generally six to eight weeks post-delivery). In the beginning, it is best to focus on low-impact exercises such as walking. Then, as the body’s core strength increases, the focus should be on strengthening exercises for the muscles.
What diet is to be followed after delivery? Should it be different from a normal diet?
Irrespective of the exercise regime, a customised diet plan must be created for each woman after they have delivered a baby. This plan must focus on the patient’s eating preferences, food habits and health status. The meal should focus on daily meals spread throughout the day, involving three main meals and two to three minor meals or snacks. Further, individualised calorie goals should also be considered, depending on the woman’s BMI, breastfeeding status, and activity levels, with a target calorie deficit of 500 kcal/day.
The Mediterranean diet is considered a good option for postpartum women. This is because this diet focusses on a high intake of fruits, vegetables, whole grain cereals, legumes, fish, and nuts; low-to-moderate consumption of dairy products and limited amounts of red meat. These are highly beneficial for maintaining a healthy body and losing weight post-pregnancy.
Post pregnancy, mothers often slip into depression and the additional weight again further impacts their mental health. So what advice do you have for such mothers who want to lose weight while taking care of their newborn?
A routine assessment for postpartum women must also include inquiry into their mental health. The presence of a diagnosed psychiatric disorder, especially depression, anxiety or eating disorder, can impact their overall well-being and must be brought to the attention of the doctors immediately. If a diagnosed psychiatric disorder is present, some medication may be prescribed, resulting in a new diet plan that considers them (as weight gain is a side effect of these medications).
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Postpartum, or the period after pregnancy, is often accompanied by weight gain for many new mothers. (Pic source: Freepik) 
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