Getting pregnant makes some women susceptible to bingeing, even when they had no previous history of eating disorders. In a study of moms-to-be ages 25 to 34, University of North Carolina at Chapel Hill researchers noted a significant jump in new cases of binge eating. Don't confuse bingeing with simply craving a specific food. Like bulimics, binge eaters consume a large amount of food in a short time and feel out of control while they do it. But unlike bulimics, they do not compensate for their bingeing by purging, fasting, exercising or abusing laxatives.
It's common wisdom that moms-to-be should be getting more calories—if not quite eating for two. But for certain women, it may be safe to cut calories during pregnancy. Obstetrician Raul Artal, M.D., of Saint Louis University in Missouri, studied 96 obese pregnant women with gestational diabetes and instructed 39 of them to exercise and follow a weight-maintenance diet; the others ate the usual diet prescribed for gestational diabetes and didn't exercise.
The average pregnant woman is advised to gain no more than 25 to 35 pounds, yet the average newborn weighs only about 7 1/2. So what's with those extra pounds? They're distributed to areas vital to your developing fetus: your uterus, amniotic fluid and placenta, to name a few (see "Where Do the Calories Go?" on the left). But experts say enough is enough.
When Ronda Kelly, A 5-foot-5-inch jewelry designer in Portland, Ore., began trying to get pregnant more than three years ago, she weighed 110 pounds and hadn't had a menstrual period in 15 years. Gaining just 8 additional pounds helped Kelly, then 34, start having regular periods again, yet it still took a total of a year of trying and, finally, intra-uterine insemination to conceive her daughter, Lauren, now 2 1/2.
Until recently, guidelines for pregnancy weight have focused on helping women gain enough to avoid having babies who weigh too little. But that's about to change, according to participants in a recent Institute of Medicine (IOM) workshop on maternal weight gain.
Women who put on even a little weight after a first pregnancy have an increased chance of experiencing complications in a second one. Researchers have found that a gain of one to two body mass index (BMI) units increased women's risk for gestational diabetes, hypertension and large-for-gestational-age babies by 20 percent to 40 percent.
You may want to keep a close eye on the scale during pregnancy. According to researchers at the University of California, San Francisco, gaining more than the recommended amount (no more than 35 pounds for a normal-weight woman) is associated with worse outcomes in newborns, including lower Apgar scores, seizures, infection, the need for breathing assistance and too-high birth weight. The risk of multiple bad outcomes also increases in moms who gain less than 15 pounds.
Women should lose all the weight they gained during pregnancy before becoming pregnant again, say Missouri researchers. If moms don't drop the pregnancy pounds, or if they gain weight after the first baby, they double the risk their next baby will be too large, increasing their chances for a Cesarean section. "The ideal is to have their weight [at conception] as close to normal as possible," adds study author Robert Blaskiewicz, M.D., a professor at Saint Louis University School of Medicine.