Monday, August 10, 2009

Weight loss after childbirth


We were two weeks away from her due date when my patient asked me how soon after the delivery she could start exercising again. It came as a bit of a surprise since up until that point my efforts to encourage physical activity had for the most part been ignored. She was concerned about losing her pregnancy weight.
We discussed that exercise after childbirth is safe and is important. The timing to some extent depends on the mode of delivery. That means whether the delivery was vaginal or through a cesarean section. Most physicians recommend six to eight weeks of recovery time after a cesarean section. After a vaginal delivery the timing depends on how the mother feels but probably two to four weeks after delivery would be reasonable. If the delivery happened to be complicated by tears or episiotomies then a discussion with the physician or the midwife is warranted.
Many women enjoy and relish the transformation that their bodies go through during pregnancy. Most of them however cannot wait to get back to their pre-pregnancy or even lower weight. That’s why I am asked a similar question quite a lot.
According to the Cochrane library review of the literature, weight retention after pregnancy can contribute to obesity. It is suggested that women who return to their pre-pregnancy weight by about six months have a lower risk of being overweight ten years later.
This review also indicates that probably a sensible approach would be to achieve this weight loss through a combination of diet and exercise.
Diet in this case does not mean severe calorie restriction. In order to see a sensible approach go to http://womenshealth.about.com/cs/breastfeeding/a/nursingdiet.htm .
Since my children were born I have tried to do something that doesn’t always come naturally. I have tried to exercise regularly and with a smile on my face! This is for the hope that they will see this as a normal part of daily living and not a torture to be endured either for health or weight loss.
I am a firm believer that starting your exercise routine in the postpartum period will help you reach your pre-pregnancy weight as well as act as a life lesson for your newborn.

6 comments:

  1. Dr. T,
    Great piece.
    What about nursing moms? My wife nursed our twins for the first 10 months and she felt it significantly contribued to her losing all of her 40-plus pregnancy pounds (well, they were 12 pounds, so that helped too). What role, if any, does and/or should nursing play in this process of losing weight?

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  2. Thank you for your comment. There have been many studies documenting the role of breastfeeding in postpartum weight loss. There is also evidence that exclusive breastfeeding promotes more weight loss than mixed feeding. This should add to the many already known advantages of nursing.

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  3. Dr. Eden,
    I found the best exercise was to take walks with the stroller.....long, energetic walks.

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  4. Dr. Takhsh,
    My son is going on 7 months (first child)and I am having a tough time getting back to my pre-pregnancy weight. Any tips on what to do about exercising even when I am so tired I feel like I want to throw up!?

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  5. In your experience, what is the most effective weight loss program??

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  6. I will try to address the weightloss issue more fully very soon. However just like stopping smoking different programs work for different people. I hear people tell me that "the Jenny Craig or the South Beach diet didn't work for me". Your body is not resistant to a program. It's just that it was never given a chance. The trick is to keep trying. If you fall off the wagon you set a new date and a goal immediately. Recently I have started recommending a website called dailyburn.com. The program revolves around calorie concious eating and exercise. I have found it to be very effective.

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