Weighty issues!

Losing sleep over not losing the pregnancy weight ? Well, before you blame it on, well, the pregnancy,
read up to find out what could be wrong…

The apple of Bollywood’s eye and former Miss World, Aishwarya Rai Bachchan has received a lot of flak
for not getting back to her enviable figure even six months after childbirth. With half the expectations, even less of the fl ak, and a very very poor body image, many women go through similar mental and social traumas, when they are unable to shed all that ‘baby’ fat. But is it really as easy to get back into shape as all the celeb mums like to pretend? Let’s find out…

WEIGHT GAIN DURING PREGNANCY
According to Dr Archana Dhawan Bajaj, consultant obstetrician, gynaecologist, fertility & IVF expert at The Nurture Clinic, Delhi, “When a woman is pregnant, the body weight is of the child and of the fluid around it along with water retention, fat and due to the hormonal changes during pregnancy.” In that sense, it is pretty normal – even healthy – to put on a reasonable amount of weight during pregnancy.

Most doctors base their recommendation of weight gain on the weight of the woman before pregnancy. Women with a normal Body Mass Index (BMI) should gain anywhere between 11 and 15 kg, and up to 20 for twins. Overweight women may be able to safely gain between six and 11 kg. “Though one can gain weight by 20-25 kg in rare cases, the normal weight gain is of around seven-11 kg. To maintain the required amount of weight during pregnancy, one must have a balanced diet, visit the doctor regularly, have supervised exercises and walk daily,” advises Dr Bajaj.

ONCE THE BABY IS BORN…
You may be very surprised by the way your tummy looks after birth. Your baby is out, but there it is, right around the navel: a big, round, squishy puffball that makes you look like you’re still six months pregnant! It takes time for your body – and especially your belly – to fully recover from pregnancy. Imagine your abdomen as a balloon, slowly infl ating as your baby grows. Childbirth doesn’t pop the balloon, it just starts a slow leak, albeit a steady one.

From the moment your baby is born, hormonal changes cause your midsection to defl ate, shrinking it back to something closer to its pre-pregnancy state. It takes about four weeks for your uterus to contract to its normal size. All the cells in your body that swelled during pregnancy will begin releasing their fluids in the form of urine,vaginal secretions, and sweat. And the extra fat you put on to nourish the baby will start burning off (especially if you’re nursing and exercising). But it takes at least a few weeks to see noticeable results. We’ve all heard stories of new mums whose tummies are tight and flat immediately after giving birth. Although this does happen, it’s rare. For most women, it takes months to get rid of the ‘pregnancy pouch’ – and sometimes it never goes away. Patience is key. It took nine months for your abdomen to stretch to accommodate a full-term baby, so it makes sense that it would take that long or longer to tighten back up.

BACK TO NORMAL
The speed and degree of this transition depends largely on your normal body size, how much weight you gained during pregnancy, how active you are, and your genes. Women who gain less than 13 kg
and exercise regularly during pregnancy, who breastfeed, and who have had only one child, are more likely to get slimmer quickly.

Breastfeeding helps, especially in the early months after childbirth. Women who breastfeed burn extra calories to make milk, so they usually lose pregnancy weight more quickly than their non-nursing counterparts. Nursing also triggers contractions that help shrink the uterus, making it a workout for the whole body.

Exercise also helps. Whether it’s a stroll around the block or a postpartum yoga class, physical activity tones stomach muscles and burns calories. A rigorous exercise regimen that includes an aerobic workout and movements that focus on the abdomen can work wonders. (But before starting an exercise routine, make sure your body is ready. Check with your doc.)

low-calorie diet can help you lose weight, but give nature and exercise time to work first. Be warned, for, as Dr Bajaj says, “While lactating, one should not go for aggressive diet or exercise.” Something moderate like walking and swimming should be good enough. Wait at least six weeks (preferably several months, especially if you’re nursing) before cutting back on calories. Dieting too soon after giving birth may reduce your milk supply and can make you feel more tired. Ask Dr Bajaj what is the best way to lose weight the natural way, and she sums it up, “To begin with, do not over eat. While lactating, your body needs just 500 calories over and above a non-lactating woman, so focus on a nutritious diet that meets this requirement. If required, take a supervised diet planned by an expert
dietitian, do exercises under the supervision of a qualifi ed trainer or a physiotherapist. Instead of fried and sweet dishes, have a lot of water, fresh fruits and vegetables.”

CAUSE FOR WORRY
Dr Bajaj states that, “One should ideally lose weight with proper diet and exercise in the first three-six months. However, if you do not lose weight in the next nine months, then you should consult a gynaec.” In short, it’s time for warning bells to ring!

Your doctor may suspect alternative explanations for weight gain after pregnancy or an inability to lose weight: STRESS: Becoming a mum can be an exciting yet stressful situation. Many new mums and even mothers having subsequent children find themselves under a great deal of stress just caring for their children. Stress triggers a chemical reaction in the body hardwired from ancient times when stress
usually meant mortal peril. The response releases certain hormones including cortisol that can increase appetite and cause the body to store more fat around the midsection, which also happens to be where most postpartum mothers have that pouch! Many people also have formed a behaviour tendency to eat in reaction to stress and may not even notice they are doing so. Dealing with stress can be as simple as taking a few minutes a day to relax, scheduling a massage as often as you can or cutting down on work hours and increasing play time.

SLEEPLESSNESS:
Lack of sleep can contribute to weight gain. In her article, Sleep More to Lose Weight, Mary Shomon discusses a recent study that found that women who slept fi ve hours a night were more likely to
gain weight than women who slept seven hours a night. The reasons? Some studies have shown that losing sleep could affect metabolism by making you feel hungry, even if you’re not. Sleep deprivation may affect the secretion of cortisol. There’s also a theory that we move around less when we don’t get enough sleep, which means we burn less calories. Make sleep a priority by trying to get to bed at the same time each night, shooting for about eight hours, if you can manage it. Having some bedtime rituals such as a hot bath or sometimes writing down your worries can help you unwind before bed. You can also try power napping, which can be a great way to reduce stress and increase your productivity.

DEPRESSION:
Nearly half the women across the globe experience some form of depression after pregnancy. Postpartum depression can range anywhere from a little case of the baby blues, to a more serious
form of postpartum depression to even psychosis. This may have have a number of causes including hormonal changes, brain chemistry changes, lifestyle infl uences, stress, and genetics.

Why depression often leads to weight gain or an inability to lose weight is not clear. Some studies suggest the same hormone linking stress to weight gain cortisol may be responsible. Others feel that depression often causes a lack of motivation and drive, which can lead to less or less than properly
performed exercise. Depression may also lead to emotional eating.

THYROID PROBLEMS:
According to experts, many women experience thyroid problems after pregnancy. Called postpartum thyroiditis, this condition causes unstable levels of hormone production by the thyroid ranging from too much (hyperthyroidism) to too little (hypothyroidism). While an overactive thyroid will result in weight loss, an underactive thyroid will result in weight gain. The overall instability of the thyroid in women
with this condition can cause simply no weight change even with exercise and diet. Thyroid problems will sometimes resolve themselves after a pregnancy and sometimes require treatment.

HORMONAL AFTERMATH:
Pregnancy, labour and what follows all have a dramatic effect on the body’s hormone balance. These
fluctuations can wreak all sorts of havoc, including weight gain or an inability to lose weight. As many women consider a birth control method after pregnancy, this can also increase hormonal imbalances.
Hormones affect a woman’s metabolism, when they are not balanced and working correctly weight gain, loss, or inability to change ones weight can result.

MEDICAL SYNDROMES:
There are several syndromes that can cause weight loss issues that are not pregnancy related but
may become more prevalent during or after pregnancy, including:
Cushing’s syndrome, which also releases cortisol.
Polycystic ovary syndrome, which causes severe hormone imbalance.
Sydrome X or insulin resistance, which causes hormone ineffi ciency.

TACKLE IT HEAD-ON
As Dr Bajaj says, “Very often, the reasons for not being able to lose pregnancy weight are lifestyle related, which include wrong eating habits, lack of exercise and excess of fatty food. To tackle this, one should have a balanced diet and exercise.” But be vary if all else fails. If you have come to the conclusion that you are doing everything right, (including getting a nutritionist, a qualified trainer AND nursing your baby) and still not losing weight, or putting on more weight instead, it is time to see a doctor to rule out any other medical condition.

In a nutshell then, cut yourself some slack (and poor Ash too!), hit the gym, eat well, feed your soul and most importantly, enjoy your new motherhood. If all’s well with you, you could fi t into those denims from last year very soon again! M&B

Words Swati Chopra Vikamsey
Visuals Mother & Baby Picture Library