Baby Weight Wars

A recent People Magazine cover featured Kate, Duchess of Cambridge, and Kim Kardashian. According to popular opinion, one hasn't gained enough weight during pregnancy and the other much too much -- a perfect opportunity to educate a judgmental public.
05/15/2013 05:28 pm ET Updated Dec 06, 2017
NEW YORK, NY - APRIL 22:  TV personality Kim Kardashian attends the E! 2013 Upfront at The Grand Ballroom at Manhattan Center
NEW YORK, NY - APRIL 22: TV personality Kim Kardashian attends the E! 2013 Upfront at The Grand Ballroom at Manhattan Center on April 22, 2013 in New York City. (Photo by Jennifer Graylock/Getty Images)

Standard grids suggest a pregnant woman should gain between 25-35 pounds. By the early 1990s, authorities recognized that underweight women might need to gain more weight and women who conceived while overweight may not need to gain as much. Today, weight gain during pregnancy gets plenty of attention, but not always for the right reason.


Earlier this month, the front cover of People Magazine featured Kate, Duchess of Cambridge, and Kim Kardashian, both at six months of pregnancy. The headline suggested that the world is weighing in on their respective pregnancies. According to popular opinion, one hasn't gained enough and the other much too much -- a perfect opportunity to educate a judgmental public.

It doesn't seem fair that some women get to enjoy "basketball pregnancies" -- those pregnancies that you generally can't tell if she is pregnant from the back. Other women get pregnant all 360 degrees around. Contrary to popular opinion, this is not entirely due to their diet. Just what makes pregnancy so different for different women?

Rising hormone levels support pregnancy and these hormone levels change how the body metabolizes energy, but all pregnant women don't experience the same change. Five of the primary hormones are known as "diabetogenic" -- that means that these hormones change the way the pregnant woman's body metabolizes energy, much like a diabetic. The shift in hormones actually makes a pregnant woman's metabolism very efficient. If a pregnant woman is prone to weight gain, she may gain fat weight more easily during pregnancy than at any other time of her life. This is a time women need support and compassion, not judgment.

Pre-pregnancy Metabolism Offers Clues

How the body metabolizes energy before pregnancy can hint at what may happen during pregnancy. The following conditions suggest greater risk for poor metabolic health and can result in rapid weight gain during pregnancy:

  • Under-weight before conception
  • Under-eating or chronic dieting before conception
  • Tendency to gain weight in the belly
  • Use of fertility drugs before conception
  • Prior diagnosis of poor metabolic health, including PCOS, insulin resistance, or type II diabetes
  • Tendency to hold excess weight in the belly
  • Excessive stress, poor sleep, or other factors that negatively impact metabolic health
Encouraging Strong Metabloic Health for Every Pregnant Woman

Weight is not a reliable marker for health, but how a woman gains weight during pregnancy is a good indication of what is happening metabolically to both her and the baby. Early and rapid weight gain is linked to increased risk of gestational diabetes and metabolic problems for the next generation. Babies born to women with gestational diabetes are more likely to be diabetic as adults.

Pregnancy is a challenging time for most women, but it is a whole lot easier when your body is able to metabolize energy effectively, not just efficiently. What can help?

  1. Adequate sleep and rest -- the body is stressed when it isn't rested. Excess cortisol only makes the metabolic challenges of pregnancy harder to manage
  2. Enough physical movement -- all activity helps improve how your body burns both glucose and fat for fuel. With extra weight and more blood to circulate, pregnant women don't have to work very hard for their body to benefit. Your doctor, dietitian or trainer* can provide guidance.
  3. A whole food-based diet with a good enough balance of protein, plant foods and healthy fats. Avoid getting over hungry or overeating. Adequate protein at each meal contributes to a sense of satiety and helps improve your sense of energy over time.

If you find yourself gaining weight rapidly during the early months of pregnancy, ask for a referral to a dietitian who specializes in maternal and infant nutrition. Understanding how your metabolism works is invaluable at any time, but especially during pregnancy. Every day, pregnant women create the future metabolic health and well being of their child.

* Certified athletic trainers, certificated exercise instructors, physical therapists and exercise physiologists can be good resources.

How Much Is Baby? Lots of tissues grow to support a healthy pregnancy.
  • 6-8 pounds Baby weight
  • 6-7 pounds Amniotic fluid and blood
  • 2-3 pounds Placenta
  • 2-3 pounds Breast tissue
  • 2-5 pounds Uterine tissue
  • 5-9 pounds Maternal stores for delivery and breastfeeding