Weight gain during pregnancy is expected and the failure of any pregnant woman to gain weight during a pregnancy is definitely cause for concern. However, coupling our food abundant modern environment with an “eating for two” philosophy is a recipe for disaster for many women. When I work with women of childbearing age and discuss plans for pregnancy, I make the point that these nine months are the most critical time in your life to follow a healthy eating plan. Because your body will naturally increase your set point, it is critical to avoid processed foods and inactivity to ensure that your set point elevation does not increase beyond the 20-30 pounds that it needs to support a healthy pregnancy. After delivery, your hormonal state will return to normal and your set point usually returns to within a few pounds of your pre-pregnancy weight. However, if you fan the flames of your elevating set point by eating large amounts of processed, calorie dense foods, the additional weight gain caused by the processed foods may not be corrected after your body returns to its normal hormonal state.
Furthermore, the “eating for two” advice given to pregnant women must be adapted in response to our increased understanding of the causes of obesity. These nine months are not only critical to your own future body weight, they will also strongly impact your child’s future. A fetuses in-utero environment plays a critical role in that child’s future relationship with food and tendency to gain weight.
Menopause also results in set point elevation in many women. While most women gain only five to ten pounds from the hormonal changes of menopause, some can gain 30 pounds or even more. In my experience, postmenopausal women are the most difficult group of patients to help to lose weight when we opt for non-surgical treatment programs. For reasons that we do not fully understand, menopause can cause a significant change in your fat storage metabolism making you very resistant to using nutritional means to achieve weight loss. However, I have not found menopause to be a significant obstacle to weight loss after surgery. I am usually quick to recommend adding surgery to a postmenopausal woman’s weight loss treatment.