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Overweight and obese women face a greater risk for complications during pregnancy.
Overweight and obese women face a greater risk for complications during pregnancy.
According to the US Centers for Disease Control and Prevention, 45% of women are overweight or obese at the start of their pregnancies. Meanwhile, study results published in Obstetrics & Gynecology show that more than 47% of women put on too much weight during pregnancy.
Pharmacists can provide the following counseling points for pregnant women who are overweight or obese:
1. Keep in contact with the whole health care team.
Overweight and obese women may require specialized treatment and attention during their pregnancies, so it is important for them to maintain regular contact with all of their health care providers.
One of the major health risks among obese and overweight pregnant women is the greater potential for gestational diabetes. It is critical to diagnose and treat this condition as soon as possible to avoid complications for both mother and baby, which may include hypertension or preeclampsia.
Pharmacists can also make sure that all pregnant patients are not receiving medications that are contraindicated during pregnancy, such as statins for high cholesterol.
2. Don’t start a restrictive diet.
Restrictive “fad” diets may inhibit a pregnant patient’s ability to keep pace with the nutritional needs of her baby.
The Mayo Clinic’s pregnancy weight gain guidelines indicate that overweight pregnant women should gain 15 to 25 pounds during their pregnancies, while women who are obese should aim to gain just 11 to 20 pounds.
Although the baby does not need extra calories during the first trimester to grow, overweight expectant mothers should add between 250 and 450 calories to their diets per day, while obese expectant mothers should add between 200 and 370 calories per day during the second and third trimesters.
In general, all pregnant women should try to consume more folic acid, calcium, iron, and other essential nutrients. Pharmacists can help patients select a daily prenatal vitamin to help fill any nutritional gaps. Many are available in both prescription and OTC form.
3. Increase the amount of moderate physical activity.
The benefits of moderate exercise for both maternal and neonatal health outcomes are consistent and include improved cardiovascular function, increased psychological well-being, and reduced risk for gestational diabetes or operative birth.
Women’s perceptions of an active lifestyle during pregnancy may be skewed, so pharmacists are well placed to identify barriers preventing a pregnant woman from maintaining a healthy level of activity.
A 2014 study published in BMC Medicine found that overweight or obese women who received dietary and lifestyle advice increased their fruit and vegetable intake while simultaneously reducing the percentage of dietary energy derived from saturated fats.
4. Develop a post-pregnancy weight management plan.
Although pregnant women who are obese or overweight should not begin an intensive diet or exercise regimen, it is important for them to begin to construct a weight management plan for their post-pregnancy health goals.
Pharmacists can be an essential resource for obese and overweight patients by encouraging them to pursue long-term weight management goals as opposed to quick-fix OTC products.
“The focus of counseling is 2-fold: initial weight loss and sustained weight loss,” Guido R. Zanni, PhD, previously wrote. “Sustained weight loss is especially problematic—up to 95% of patients regain their weight within 5 years. …[However,] up to one-third of obese patients achieve longer-term weight loss when interventions include diet, drugs, and counseling.”