My Ob Put Me On A Diet!

[mommyagain]

I went in for my normal checkup on Thursday, and found out that I gained 12lbs in 4 weeks! I'm 16 weeks pregnant and have gained 19lbs! My doc was NOT happy... well, neither was I. I have not been weighing myself at home because I have had emotional problems with weight in the past, and I was told that during pregnancy, it's best to put the scale away. Well, now my doc wants me to come in every week for a weigh-in. I just don't feel like I'm eating that much, and I'm not sure where to cut back.

I tried to blame the extra weight on the fact that I had been studying like crazy for a HUGE exam (professional engineering exam, similar to medical boards or bar exam). All of my friends who have been studying for the same test have gained at least 10lbs in the last month or two... and they're not pregnant! My OB basically looked at me like I was crazy.

She said that I should not gain any weight at all over the next 4 weeks, then keep it to less than 1lb per week. I know the "risks" of gaining too much weight... and I know it'll be harder to lose it later... but isn't it my problem if I gain too much weight? I hate feeling hungry, and now that I'm not sick all the time, I'm beginning to enjoy food again (maybe too much?). Really, what can my doc do if I don't come in for the extra weigh-ins... or if I keep gaining weight. Not that I want to keep gaining 3lbs/week... but if I do, it's my problem, right?

I took my exam on Friday. And ever since, I have been stressing about how to stop gaining weight. Today, I found myself writing down the calories in everything I ate... which is one of the things that I used to do when I was anorexic. I don't want to go down that road again, so as soon as I realized what I was doing, I crumpled up the paper and threw it away. I don't want to keep a food diary for the same reason... but my doc suggested that as a way to keep track of things. She knows about my history simply because I checked the box on the new patient form for anorexia, and I remember she asked me about it at my first appt with her last year, before I was pregnant. I know she probably hasn't looked at that part of my file in a while, but asking a (recovered) anorexic to keep a food diary seems to be a bad idea to me. Any ideas?

[tarnalberry]

recent research suggests that maternal weight gain does affect the child, primarily in the chance of having difficulty maintaining a normal body weight and in diabetes risk, later in life. how big of an impact? how clear a connection? I don't think anyone knows. but the changes that *you* undergo do affect your child too.

perhaps keeping a close record of what you're eating may help? given the concerns you bring up, I could understand you not wanting to do that, though...

[Ridgewalker]

Um, yeah, mommyagain I completely agree with you. Your doc probably has forgotten that you have a history of anorexia and made a really dumb suggestion! While a food diary can be very helpful for a lot of people, it doesn't seem to be a good idea for you. And weekly weigh-ins seem way extreme to me!

During my pregnancy, I had gained about the same as you at about the same time. The doctor scowled and told me not to gain any more weight for the entire pregnancy! I walked out of there in tears, and sat in my car sobbing for I-don't-know-how-long. (I, too have had weight/body issues.) Luckily, that doc was one in a practice of seven doctors, and I refused to see him again. None of the other six docs said anything so extreme.

It makes me absolutely furious when doctors instill a weight paranoia in pregnant women!!! Everyone knows you shouldn't gain too much weight during pregnancy because of the higher risk of gestational diabetes, which is unhealthy for both mother and baby. But a simple reminder would have been good enough!

Not to mention that pregnant women retain water like camels- I know I did, especially during my second pregnancy. Water is heavy, and it WILL contribute on the scale.

My thought is, now that your exam is done, you'll have one less stress to handle. You were probably eating a lot of quick, junky comfort foods. Cut back on those, and don't worry about the rest!

Whether you should comply with the weigh-ins, that's your call. If it were me, I'd be very reluctant to do that as well. That would be incredibly stressful for most pregnant women, and even more so for a recovered anorexic. I think you should call the office and leave a message for her. Say that, as a recovering anorexic, you feel that it would be unwise to have such frequent weigh-ins. That you're dealing with your nutrition as best you can, and you'll be happy to discuss it with her next month.

That's just my generally-not-so-humble opinion.

((hugs!))

[CarlaB]

I ate normally and gained 60 pounds with my first pregnancy. I lost all but 10 by 6 weeks post-partum without dieting. In fact, I was breastfeeding and eating like a horse!

With my next pregnancies, I gained 25-35 pounds eating the same way (I had five babies).

I really think that sometimes you gain a lot with the first one, then your body learns what it's doing. However, perhaps you have taken being pregnant as license to eat all the time? Just be sure everything that goes into your mouth is something that is going to provide nutrition. Just cutting out junk and sugar will probably help you keep in a reasonable range.

I had to cut out all sugar due to some meds ... after 10 months of it, I am surprised how much better I look and how much trouble I actually have keeping my weight up!

If you go in next time and can say that you have been eating nothing but healthy stuff and gained the weight anyway, then you won't have any arguments from your doctor ... plus you will then be less likely to have bloodsugar problems.

[mommyagain]

This is actually my second pregnancy. First pregnancy, I gained 10lbs in the first 6 months, and almost 40 in the last 3! Of course, I didn't know I was pregnant for the first 6 months and was dieting like crazy to try to keep from gaining weight!

Now, I feel like I'm eating normally but gaining a lot of weight. Also, up until I got pregnant, I was keeping track of body measurements. Basically, I'd measure myself once a month or so. I always felt like that was a healthier way to keep track of things than weighing.

So, this morning I pulled out the tape and measured my legs, hips, upper arms, bust, and ribs. Hips are up 1/2", and bust is up by 2". Everything else is the same as pre-pregnancy. Obviously, I didn't measure my waist. But, after the measurements, I feel like all of the weight is going strait to the breasts and belly, which is round, but not flabby.

I have to go in this week because I have an ultrasound scheduled, and they'll weigh me then. But, I think I'll skip the rest of the weekly weigh-ins until my next appt and then explain to the doctor that I'm not comfortable with being weighed weekly.

[tarnalberry]

I have to go in this week because I have an ultrasound scheduled, and they'll weigh me then. But, I think I'll skip the rest of the weekly weigh-ins until my next appt and then explain to the doctor that I'm not comfortable with being weighed weekly.

Since it's a delicate balance between a number of things, health wise, and you know your body far better than your doctor can, that's probably reasonable. It may be a good idea, however, to call in and leave a note for your doctor - before you start skipping appointments - and note that you will not be going to your weekly appointments with a *very brief* explanation of why. Finding the line between being a noncompliant patient, being a whiney/demanding patient, and just being a vocal one may be difficult, but may also affect the care that you get. I'm not saying it should, just that doctors are human too, and have to adjust to the people they see.

[mommyagain]

It may be a good idea, however, to call in and leave a note for your doctor - before you start skipping appointments - and note that you will not be going to your weekly appointments with a *very brief* explanation of why.

The weigh-ins aren't actually appointments... I'm just supposed to stop in every Thursday or Friday, have a nurse weigh me, and enter the weight on my chart. I might leave a note for my doc this week when I go in for my ultrasound. I just don't want to get into a long detailed discussion about my past weight issues.

[melmak5]

It sounds like the weekly weigh-ins are one tool, and perhaps can be viewed as a suggestion.

If you don't want to go into your past history, I think its completely reasonable to say that coming in once a week to step on the scale is not something you can fit into your schedule right now. Give the doc some line about how you know how important it is to eat "healthfully" and call it a day.

You know your body better than anyone else. It sounds like its more important for you to be physically and mentally well for yourself and your baby.

[Michi8]

Pregnancy is not a time for dieting. If you are going hungry to keep this doctor happy, you are risking the health of your growing baby.

I gained plenty of weight in my pregnancies. 25 lbs with the first, 40 lbs with the second, and 60 lbs with the third...I started at different weights each time, but ended up at the 180lb mark at the end of each pregnancy (I think my body needs to be at this weight for proper prenancy health.) All three of my kids were born at a healthy weight (8lbs 6oz, 9lbs 8oz, 9lbs 12oz) and I had no troubles with gestational diabetes. BTW, I lost all the weight each time with extended, on demand breastfeeding.

I really believe that to be healthy in pregnancy, one needs to eat & drink to hunger and thirst, and make healthy food choices. Weighing-in is of questionable value, and only creates more stress regarding whether one is gaining "enough" or "too much" weight. You're going to weigh what you're going to weigh.

Michelle

[Nancym]

Watch the sugars and starches! A lot of research is suggesting that you can set your kid up for obesity and diabetes later on in life by having a lot of insulin yourself. And you secrete loads of insulin when you eat sugars and starches. So stick to good quality, low starch sources of protein like animal based ones and nuts. Eat plenty of fat, ignore the low fat nonsense (because people replace fat with carbohydrates and get crazy insulin levels and subsequently fat) and it'll keep you feeling full longer, and it'll suppress cravings for carbohydrates. Eat lots of leafy green and low starch veggies and moderate amounts of fruit. Anyway, it has helped me lose 50 pounds and I've successfully kept it off many, many years this way. There is no need to restrict calories this way either. There's nothing in starches or sugary foods you can't find in vegetables, meat, fruits and nuts and dairy products if you want to eat them.

[mommida]

I gained more than the reccomended 25 to 35 pounds for each pregnancy (before Celiac ).

First I was getting spoken to harshly for not gaining weight, then at four months pregnancy too much weight gain. Honestly I was starved at the beginning and ate more when I was NOT gaining weight. When I felt like I wasn't as hungry and just added an extra snack to balance out what vitamin or mineral my meals were lacking, then I gained weight.

It might have to do with Celiac being an auto-immune illness that starves your body. In pregnancy your immune system goes into a less functioning state, or the fetus would be harmed.

Take care of yourself, eat healthy, excercise, avoid sick people, and get proper rest.

I really stress the excercise. Even if you didn't excercise before, pick something non-stressing to your body and stay in shape for delivery.

Don't stress yourself out about this. Tell the doctor honestly what is going on. Keep a food journal for proof of your diet, activity, and weight. If there is a reason to suspect any problems, that would be the only way to get any help. (Because they just don't seem to believe you when your pregnant.)

Laura

[Ursa Major]

I agree that dieting is a terrible idea during pregnancy. You've had good suggestions about limiting carbs and sugars, and eating meat, vegetables and fruit for the most part. And make sure you take vitamins.

Weekly weigh-ins are ridiculous! The absolute worst thing for you to happen is, to start stressing about gaining too much weight, and possibly sliding back into anorexia. Because that would endanger both you and the baby.

If you eat healthy, I don't believe you will be in danger of gestational diabetes, even if you gain a lot of weight. And predisposing your baby to get diabetes later on in life if you eat healthy is not a likely scenario, either. Getting some gentle exercise is a good idea, too.

If your doctor is stressing you out too much, and won't let up on this nonsense, you may be better off trying to find a new doctor for the remainder of your pregnancy.

With my third pregnancy I had a dumb doctor, too, who lectured me on not eating so much, because then my baby would get too big (I had a c-section with my second child, and he was 'allowing' me to attempt a vaginal delivery). He was basically threatening me with another c-section if the baby would get too big.

Which when looking back now, was absolutely terrible, especially knowing now that generally, a bigger baby is often a healthier baby!

And then I had to listen all the way home to my husband berating me for getting too fat (I wasn't driving then, I got my driver's license when I was 35).

Needless to say, I'd cry for days. I was totally stressed out during that pregnancy as a result, which wasn't good for me, the baby, or my two toddlers then (I ended up being severely depressed).

I wished I'd have had the courage then to insist on finding a different doctor, and standing up to my husband, who basically forced me to stick with that doctor, like it or not. Because if you aren't comfortable with your doctor, especially during pregnancy, you need to find somebody else if at all possible. Pregnancy is supposed to be a happy time, and the last thing you need is added stress.

[Juliebove]

I hope your Dr. checked your thyroid. Mine went out of whack when I was pregnant. I was already on a set diet due to gestational diabetes. One week I gained 10 pounds. The next week I lost 10 pounds. My Dr. freaked! But it wasn't my fault. It was my thyroid.

In the end I gained a total of 12 pounds. But I did have gestational diabetes and they don't really like you to gain much if you have that.

The diet I was put on did not focus so much on calories, but instead told me how many servings of each thing to eat. For instance, 2 servings of starch (15 g of carb per serving), one of protein (1 egg, 1 oz. meat, 1 T. peanut butter) and one of fat (tsp. butter) for breakfast. Lunch was three servings of starch, 2 of vegetables (serving = 1/2 cup cooked or 1 cup raw), 3 of protein. Dinner had a little more protein and starch. Snacks were supposed to be fruit, but I don't much like fruit. Or snacks. So most of the time I just didn't eat those. I did have a snack before bed and that was almost always a big bowl of popcorn and a piece of cheese. I didn't drink milk at all back then but I did eat cheese because I didn't know of my dairy allergy.

I can't say that I liked the "diet" I was put on, but it did make things easier in terms of deciding what to eat. My husband was away most of my pregnancy. He's in the military. So I was making meals just for me most of the time. If I dined out, I knew which meals I could eat that would fit this eating plan. I had a few different meals that I alternated at home. That might not work for you, but it worked for me. I am the type who tends to eat the same things over and over again until I get burned out on them and then I switch to something else.

Mainly I tried to focus on good nutrition. Plenty of vegetables in all different colors. Enough protein. Some fat. I learned that I wasn't eating enough fat. My normal diet was very low in fat. And little to no junk food. Luckily, I didn't have too many cravings for stuff I shouldn't have eaten. I did occasionally want chocolate. What I did was buy those mini M & M's in a plastic tube. Do they even make them that way any more? When I wanted chocolate, I would have 2 or 3 of those and it was enough to satisfy me.

[mommyagain]

I have thought about getting a new doc. I ended up with this one because I was due for my yearly checkup a few months after I moved. I didn't know anyone well enough to ask who they went to, so I had my husband ask a few of the women he worked with. Two of the three recommended the same doctor so I called her office. She wasn't taking new patients, but another doctor in the practice was. So, that's how I got her.

The thing is, I like her, except for the weight thing. She had absolutely no problem with putting celiac on my chart, even though I'm self diagnosed. She even spent 10 minutes digging through all the prenatal vitamin samples they had to find one that was gluten-free.

I think for now, I'm going in for my ultrasound on Friday, but won't actually see my doc. They'll weigh me then, but after that I'll wait til my normal appt to go back in. If she asks about the weigh-ins then, I'll explain why I don't think they're a good idea for me.

Luckily, my hubby did not go along to my last appt, and probably won't go to the next one because he's scheduled to be out of town. As long as no one mentions my weight at the ultrasound (I doubt they will) he doesn't have to know that it's a "problem". He totally does not understand my emotional issues with food, and ALWAYS tries to follow the doctor's orders. So, if he knew I was supposed to be keeping a food diary and going in for weekly weigh-ins, he would probably try to make me, and wouldn't understand why I didn't want to. He would also give me a "look" every time I ate something, healthy or not.

Thank you all for your responses. Definitely made me feel better about how I'm dealing with this.

[mommyagain]

Well, I think I know why I've been gaining so much weight. Please see my new post in the sleep forum Open Original Shared Link.

Thanks for any suggestions on how to deal with this.

Btw, I weighed myself at home this morning and I've gained another 3lbs since last Thursday. I've got my ultrasound tomorrow and I don't wanna go because I know they're going to weigh me.