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Obesity and Reproduction

I tried to post interesting tidbits from the Obesity and Reproduction conference on Twitter last week.  It worked great until I ran out of phone battery.  So I promised to share some of the more interesting things I learned here.

The biggest take-away message for me was the importance of treating each client as an individual. This means I need to understand who she is and what struggles she is facing.  Why does this relate to obesity and reproduction? Because the standard advice of eat less and exercise more just doesn’t cut it for most overweight and obese individuals.  And really, if it were just that easy wouldn’t more people be successful?

I should not have been as surprised as I was to learn about the different factors of obesity.  After all, I have struggled to maintain a healthy weight my whole life.  I’ve had the unpleasant experience of watching the scale go up instead of down no matter how hard I work-out.  I have been so afraid to eat that I skip meals, only to find the scale still will not budge. The whole time I tell myself that people do get thinner when they are malnourished, and that if I just keep cutting down calories and exercising more it will work. And I am successful, at least in the short term, but my gains are few and quickly lost.

Before I delve into some of the research and suggestions, I want to simply pause and think about what it means to be obese.  Not the clinical definition, but what happens to a person who is obese.  What happens to your self-worth when everyone tells you the problem is you.  What happens to your self-concept when diet after diet doesn’t give you the weight loss promised.  What happens to your social life when you become too big to comfortably fit in chairs at restaurants or theaters? What happens to your motivation to improve your health when you are told it is your moral failure that causes you to be overweight – you simply lack self-control.

I bring this up because a woman is more than a uterus. Pregnancy is affected by her total health, and will affect her total health.  To help women achieve their optimal state of health during pregnancy you need to understand all the factors that affect her health.  And while the tendency is to focus on obesity as an issue affecting her health, I encourage you to take a step back and understand that obesity is part of her state of health and other issues are affecting obesity.

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Jennifer Vanderlaan CNM MPH is the author of the BirthingNaturally.net website. She has been working with expectant families since 2000, training doulas, childbirth educators, and midwives. She has worked with midwives in Central America and Sub-Saharan Africa. Her interest in public health grew in 2010, and she is now a PhD student learning to become a producer of knowledge.

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