Recent Podcast
I shared this on IG stories last week, but wanted to share the link here since IG stories only stay up for 24 hours. Samara from the Grapefruit and Granola podcast invited me on to talk about Health At Every Size, how women can advocate for themselves to receive the best health care possible, and we also chatted about PCOS. I love doing podcasts and sharing this message so I hope you find it helpful + enjoyable.
Afternoon in Providence, RI
I have a really close girlfriend who lives in New Haven, CT. We actually met about 6 years ago in Charlottesville and then she got married a couple years ago and moved to Connecticut. I was living in New York at that point and it was so nice to have close friend from Charlottesville only be a short train ride away. Thankfully, even though we moved to Boston, we are still less than 2 hours away. On Saturday, we planned to meet halfway and decided on Providence, RI for a meeting spot. I think it’s so crazy how we can both drive an hour and end up in a different state. There are so many tiny states up here vs the midwest where growing up, we would drive for 4 hours and still be driving through the same state!
We ate lunch at a cute restaurant that Jess found called the Grange. We split jalapeño hush puppies with maple butter to start and then I got the oyster mushroom po’ boy with slaw and pickles on a pretzel roll that was amazing. The food was insanely good and I’d go back over and over. It was raining so we couldn’t walk around which was a bummer, but it was still a great afternoon. Seeing Jess made for a happy Saturday.
The Comfiest Leggings Ever
I had resisted buying these leggings from Lululemon for a really long time because I’m not a fan of their marketing. I own a handful of workout tops and leggings, but over the past few years as I got really clear and rooted in my professional practice that centers around Health At Every Size, Lululemon has increasingly pissed me off. I hate how they make their clothing so tiny so that the larger sizes fit “average” sized bodies. What are larger bodied people suppose to wear? And I also hate how their marketing only shows super fit, small bodied women with flat, toned stomachs. I’m venting here, but it makes me so mad! I realize that aren’t many clothing companies (if any?) that are HAES aligned, but I do appreciate how Athleta’s sizes are more in line with what’s “normal” and that they have plus sizes and larger bodied women in their marketing.
Now that I’ve just ranted on about how annoyed I get with Lululemon (and I’m over here ranting about overpriced athletic clothing..) I did finally cave and buy the Align legging after several girlfriends raved about them on multiple occasions. I had a gift card from Christmas that I used to buy them and ohhh my goodness they are like butter on my legs. They don’t have that compression feeling a lot of leggings have, but instead are super light weight and feel like you’re wearing almost nothing. If you want to avoid the store and all that jazz, I’d recommend just ordering them online since you get free shipping.
Post Baby Body and Weight Gain During Pregnancy
I don’t have the personal experience to speak to this yet, but I do think this is an important topic and one I’ve been thinking about a lot as I work with pregnant and postpartum clients and have friends currently going through this life stage. I had a reader email me last week about pregnancy weight gain her doctor commented on and several readers reach out to me about the pressure to get their “pre baby body” back.
One shared that she is 12 weeks pregnant and at her last doctor’s appointment, the doctor brought up her “rapid” weight gain as a concern which led to her doubting herself and feeling a lot of negative emotions. Health care providers have a lot of influence and so what they say to us as patients can have a profound effect on how we think about ourselves. I ended up emailing this reader back with a few sentences of empathy and encouragement because I just felt so much for her. Any woman at 12 weeks pregnant, when she’s already highly vulnerable and has so many emotions she’s carrying with her, does not need her weight highlighted to her by her health care provider. And in my opinion, I think that sends a really loud and clear message that the health care provider isn’t seeing this patient as a whole person. Instead we are zooming in on the numbers attached to her chart and making misinformed assumptions based on a few objective values. Health care providers – whether that’s a physician, nurse practitioner, or physicians assistant are well intentioned and they want to do good for their patients. They really do. But unfortunately, we are all trained through the lens of diet culture and weight is heavily emphasized in our training as a measure of health. That sucks.
If you’re pregnant, or if you’re not pregnant and have experienced a comment about your weight from your doctor that made you feel bad about yourself and/or prevented you from returning to the doctor and getting adequate health care, I’m sorry. To that reader and anyone else reading who is pregnant or might one day receive the gift of pregnancy, know that your body knows exactly what it needs to do to grow your baby. Your job is to care for yourself, not micromanage your body size. And your health care provider’s job is to care for you medically and guide you toward behaviors that keep you and your baby as healthy as possible – their job is not to micromanage your body size. I read in one of Kylie’s posts a while ago that when her OB brought up her weight at one of her first appts, she replied with something like, “My body knows how much weight to gain to grow this baby, so I don’t think that is a concern for either of us.” End of story.
Beyond pregnancy, there is so much pressure and unrealistic expectations created within society about getting your “pre baby” body back. And there’s also this false belief that if you breastfeed, “the weight will just fall right off!” I’ve never experienced postpartum, but I can only imagine how hard this stage of a woman’s life is. A mother who has spent the last 40 weeks of her life growing another human and then either pushing said human out of her body or had surgery on her abdomen to bring that baby into the world does not need to be thinking about getting her body back. That’s the least important thing. But I can totally see how it could feel like that is really important in our culture. And that makes me really sad. Women’s bodies are incredible. I would never want to be a guy because I think female bodies are so much more interesting and can do way cooler things than a male’s body lol…I mean we can grow human life inside our bodies. That’s crazy and so awesome and how that is possible is beyond my own intellect.
What does getting your pre-baby body back EVEN MEAN? You grew a human life and birthed that human life..how could your body EVER be the same again after going through that experience? It’s not suppose to just bounce back to it’s previous shape and size like a rubber band. So if you’re a mom struggling with body image and living in your postpartum body, that’s hard and those are hard feelings to feel. But I really hope you give yourself permission to be kind and compassionate towards your fragile body knowing that your body is meant to change throughout your life. And this idea of a pre-baby body is not only unrealistic, but a complete waste of your mental, emotional and physical energy. Kylie has written so many wonderful and encouraging posts on body image during pregnancy and after birth that I hope you find helpful <3
Favorite At Home Yoga Podcast
I prefer to do yoga at a studio, but I also really love the convenience and $0 price point of doing yoga at home. If you’re looking for a good at home yoga podcast I love Yoga to the People podcasts, especially this one by Sofia. The music and her voice, in my opinion, are so on point. I loved going to the East Village studio when I lived in New York and if I dim the lights and light a candle, it almost feels like I’m right back there with these podcasts.
I have a morning full of clients and then some writing + calls in the afternoon. Have a great week!
Hi Robyn,
I love your writing and thoughts about women’s health and our bodies and agree with most of the messages that you send about Health at Any Size, but I have to disagree slightly about the pregnancy issue you brought up today. I must admit that I am a little bit biased–I’m a physician and I’m also currently pregnant–and have been thinking about how to balance a natural amount of weight gain (which for me at times has at times exceeded the recommended “per week” gain). While I understand the desire for doctors to be supportive of women and the changes their bodies go through, I do think that doctors/midwives/health providers SHOULD address pregnancy related weight gain as too much weight gain (admittedly more than happened with your friend) can have adverse outcomes for the mom and the baby. Unlike weight gain at other times in our lives, gaining too much weight during pregnancy can increase a mom’s chance of gestational diabetes, pre-eclampsia or pregnancy-associated hypertension, and risk of C-section delivery as well as a number of other complications. While I understand our role as healthcare providers to be supportive of women and their body changes, I do think we have an obligation to address issues that could potentially be harmful to a mother or a baby, instead of exclusively being supportive. Although our bodies know what to do, at times we do have to exercise caution and restraint to try and help our own bodies and the little humans we are trying to grow. I hope you don’t take this as a malicious comment at all as that’s not my intention, but I do think there are times when it is appropriate to step in to discuss issues like this. Thanks for always keeping an open dialogue.
Hi P – thank you so much for your respectful and thought provoking comment and for opening up this discussion. I agree with you – that mom and baby’s health are the health care providers main concern and something we must not overlook. And looking back on my writing here, I certainly could have and should have clarified a bit. Now that I reflect back, I certainly would have added more to this if it were a whole post (which is perhaps something to consider) – I agree with you that yes we want to make sure mom and baby are healthy (and mom wants to be healthy and have a healthy baby) but I think there is too much emphasis on WEIGHT instead of BEHAVIORS. Weight is an outcome, it’s not the concern. So instead of dialoguing about weight (which can bring about shame and guilt) can we shift the conversation and instead have empathetic dialogue about how mom feels about her food choices, how do they make her feel physically – same for exercise choices and self care – and can we focus on health promoting behaviors vs talking about weight. I think that would be far more helpful, empowering and ethical. Would love to hear your thoughts and thanks for reading!!
Thanks so much for your thoughtful response, Robyn!
I think in the end it is really tricky to balance being supportive and nurturing with providing counseling and redirection when some extra help is needed. Obviously each individual healthcare provider has to know when to make that distinction for each individual patient. I really enjoyed some of the other commenters’ posts like someone with an eating disorder history who doesn’t have her weight read out loud–what a great and sensitive way for that relationship to work with her provider.
Unfortunately weight is an objective measure and as much as I’d love to go off of subjective feelings about behavior alone, etc sometimes a number is actually important from a health consequence perspective. As a doctor, if someone’s blood pressure or heart rate are abnormal, I would address these changes in vital signs as they can be a cue to something more significant going on, and similarly if someone’s weight rapidly went up in a way that exceeds normal healthy amount, that’s something I feel obliged to discuss with a patient as well. Obviously the way we discuss these things is incredibly challenging and I totally agree that we can focus on behaviors in an empathetic way, but unfortunately sometimes it is the number that prompts us to start a discussion.
From a personal standpoint, pregnancy itself is SO WEIRD and the foods and behaviors that felt good often don’t anymore. I’ve certainly gained more weight so far than I personally expected I might, but I trust that my OB/GYN will let me know if I reach a level that was dangerous or concerning for me or the baby.
Thanks again for your openness and for starting a great discussion!
Thanks for a thoughtful conversation P! I think the distinction is “rapid weight gain” or “excessive” weight gain that would cause a doctor to (rightfully so!) do some more exploring to make sure mom and baby are healthy vs mentioning/briefly discussing a woman’s weight at each appt. Totally agree with what you said, that number can be helpful for you in then starting a discussion around behaviors, but it doesn’t have to be the focus of your discussion with the patient – I think you explain that so well here. Thanks again and congrats on your pregnancy! 🙂
+1. The doctors would be negligent to ignore excessive weight gain during pregnancy. It may not be the only data point of interest, but it’s an important one. I think this post misses the mark.
Hope the above discussion is helpful for you Kate!
I feel like there’s a really, really important distinction between educating mothers about possible indications of rapid/excessive weight gain(particularly in third trimester) and making weight gain an aspect for the mother to micromanage. Especially if there is a history of disordered eating or trauma, highlighting weight or setting out tight parameters of ‘acceptable’ weight gain can have some really detrimental results. I 100% agree that health outcomes for mothers and babies are far more dependent on nutrition, adequate protein to prevent preeclampsia, adequate rest and hydration and LESS on an arbitrary number of lbs a mom gains. The pregnant body seeks nutrition intelligently. (Oftentimes rapid weight gain is fluid and can indicate nutritional needs, not need to lose weight.)
How a doctor frames this can have a radical effect on a mothers mental health and physical health throughout her pregnancy. I personally was traumatized by my provider during my first pregnancy; I was young and vulnerable, and her expressed horror at my BMI and subsequent order to go on a low carb diet(eeek!) had me so shaken and anxious for months. That resulted in high blood pressure readings–completely isolated to my appointments, not just in that pregnancy but in my following pregnancy, like ptsd. I wish I had known then what I know now.
Now that I am in her position, I can see just how shortsighted she was, really not treating me as a whole person. It inspires me to practice differently.
Agree wholeheartedly with you Hani
As a woman who is 7 months post partum and who was made to feel like I was “huge” most of my pregnancy by people constantly commenting “is it twins?”, “you’re so big” etc etc I just wanted to state that pregnancy weight gain is something that can become concerning and more importantly affect your baby. So while it would be a perfect world to have everyone worship you, be kind and throw daisies at you while you sit on a Lilly pad while pregnant, it’s not realistic, nor is it always in the best interest of your baby. I think a doctor would be doing a disservice to their patient if they didn’t discuss it and make them aware of the issues that could plague them later on if it continues at an unhealthy rate. Unfortunately weight gain is a topic that has to be discussed in pregnancy, but hopefully those medical practitioners are doing it with the mother’s feelings and vulnerability in mind.
Totally hear you Jennifer and agree. I responded to P above who is a physician that I hope is helpful in this discussion. Essentially, I think a conversation shift that focuses on behaviors vs health would be much more helpful. And I think what you mentioned, “with the mother’s feelings and vulnerability” in mind is so on point –> couldn’t agree more
Respectfully I think you should “stay in your lane” here. You have a fraction of the education that OB has. There are very real risks with gaining too much weight in pregnancy, just as there are risks with not gaining enough. This is where I struggle with HAES. I appreciate the supportive tone, but strongly disagree that weight should be off limits for medical providers.
Hi Kim, I’ll copy my reply back to P above who is a physician herself and was able to open up healthy discussion. I think everyone is in their own lane here. I hope our conversation is helpful for you.
Hi P – thank you so much for your respectful and thought provoking comment and for opening up this discussion. I agree with you – that mom and baby’s health are the health care providers main concern and something we must not overlook. And looking back on my writing here, I certainly could have and should have clarified a bit. Now that I reflect back, I certainly would have added more to this if it were a whole post (which is perhaps something to consider) – I agree with you that yes we want to make sure mom and baby are healthy (and mom wants to be healthy and have a healthy baby) but I think there is too much emphasis on WEIGHT instead of BEHAVIORS. Weight is an outcome, it’s not the concern. So instead of dialoguing about weight (which can bring about shame and guilt) can we shift the conversation and instead have empathetic dialogue about how mom feels about her food choices, how do they make her feel physically – same for exercise choices and self care – and can we focus on health promoting behaviors vs talking about weight. I think that would be far more helpful, empowering and ethical. Would love to hear your thoughts and thanks for reading!!
Thanks Robyn, I appreciate that. I do feel that openly challenging/critiquing a medical doctor, who has no way to justify their behavior, is veering out of your lane to continue the metaphor. You have no OB training. You are an RD and direct-entry NP. As others have explained, there are countless reasons why a doctor would discuss weight. We could be hearing a biased/skewed recount of the interaction for all I know.
Hi Kim – other commenters don’t need medical/nursing degrees to make their comments valid. For what it’s worth, while I’m not an OB we did have classes and training in prenatal care – FNPs are quite regularly employed at OB offices and care for pregnant women, although you’d have to be a midwife to deliver.
Hi! Thanks so much for this post — it’s just what I needed to read today with a ob appointment this afternoon! I’m 14 weeks pregnant, and as a woman who spent years struggling with eating, exercise, and body image, I’ve found it stressful to be weighed so frequently at the doctor’s — they haven’t commented (granted, I’m small and haven’t gained much weight… thin privilege!) but I get nervous every time. I really believe that following the precepts of intuitive eating will mean that my body does what it needs to do during my pregnancy, including gaining whatever weight I will gain.
I know that excessive weight gain can be linked to complications, but gaining not enough weight is actually more dangerous to the baby (see data in “Expecting Better” by Emily Oster). And I wonder how much of “excessive” weight gain is rooted in diet culture, whether it’s because it happens in reaction to utter restriction in all other time of life (i.e. pregnancy can be seen as the one time a woman can eat what she wants…) or in reaction to the stress of trying to control weight while also being pregnant.
it happens in reaction to utter restriction in all other time of life (i.e. pregnancy can be seen as the one time a woman can eat what she wants…) or in reaction to the stress of trying to control weight while also being pregnant. –> I think you bring up such interesting and thought provoking points here Kate!!
I gained, during my second pregnancy, far more than the normal, recommended amount of weight. It was, as it turned out, a symptom of a larger problem. I had an undiagnosed thyroid problem. So, no, my body did not know how much weight to gain–it couldn’t, under the circumstances. The idea that pregnancy weight gain should be ignored and trusted is nice, but not realistic. Excessive weight gain in pregnancy can cause problems, it can also be a symptom of problems. Ignoring that ignores real dangers and doesn’t serve patients. It also doesn’t honor hurt and hurting bodies. Sometimes, our bodies don’t work–and they don’t know how much to weigh. If we trust something that cannot, at that moment, be trusted, we hurt people.
Totally hear you Kate! I think what you’re saying –> that its a SYMPTOM and not the problem is so important. So instead of being told to perhaps eats less or move more to control your weight, it was really important that your current behaviors be explored so then that could tip of your OB to explore other medical causes that might be going on and that’s how they discovered the thyroid issue. I’m by no means saying that we should just ignore issues. But if your weight gain was seen as being totally in your control I think that could have been really really harmful. Hope that helps 🙂
But until a mom has changed her diet and activity, no one is going to jump to more invasive tests.
Because you start with the easy fixes before you look for the less likely causes. So, yes, diet and exercise have to be addressed first.
Frankly, I find it troubling to read that we should trust pregnant women’s bodies implicitly. Over the history of our species, child bearing has proven to be one of the things our bodies are worst at. Last I read, one in ten of us died doing it. We still die at a ridiculous rate in the United States. For some women, yes, it’s a process that goes easily and intuitively. But for many, many other women, it’s a complicated, dangerous process. Any writing about the subject has to include both camps. Not every woman’s body can be trusted to know how much weight to gain or how to push a baby out. Not in this century and not in any of those past. And there is no way to know which body is which until it’s all said and done.
I read your blog daily and usually enjoy your writing. But having been one of those women whose health issues were missed because her midwives kept repeating,”Trust your body; it knows what it’s doing,” I cannot let public statements like this one go by. I’m sorry if this comes across as overly critical, but your blog is so good, it’s worth the dialogue.
I would hope with an open conversation the health care provider would recognize when additional testing is warranted and not force a mom to change her diet and exercise before ruling out other causes. I’ve seen a lot of OBs practice that way – but I know you had a different experience. The US could definitely improve its rates of infant mortality but I don’t think maternal fatality is 1 in 10…could you send over that resource because that is shocking! I wrote in the post, “the health care provider’s job is to care for you medically and guide you toward behaviors that keep you and your baby as healthy as possible” If the message was to just trust your body and not care for you medically, I’m sorry you had that experience and I would never want any woman to feel like her health was ignored. Health is the number one priority! I appreciate you reading and taking time to have this conversation <3
What I’ve read is that, before modern medicine, one in ten women died in childbearing. It was years ago that I read it, and I don’t remember the source. And the US has the highest rates of MATERNAL mortality in the developed world–I don’t know how it compares on infant mortality. All of which is to say that women’s bodies aren’t actually very trustworthy when it comes to pregnancy and childbirth. If they were, modern obstetrics wouldn’t exist.
Changing diet and exercise are the LEAST invasive fixes. They have to be looked at first–because you don’t put a pregnant woman on medication without trying the simpler fixes first. So, no, I wouldn’t expect a provider to go for more invasive tests and solutions before trying diet and exercise.
Yeah I agree, I thought this post was a bit problematic. And as others have said, it can seem like this is where HAES isn’t perfect and can at times fall short. Even with her having elaborated on addressing ‘behaviors’ rather than weight (which I think is a good clarification for sure); addressing bevaiors STILL wouldn’t be addressing other underlying concerns that could be at play (as you mentioned here, thyroid issues), which can do a huge disservice to both mom and baby. I guess my point is that too much weight gain and too much weight loss (in general but in regards to pregnancy as it relates to this post) can be equally problematic, yet my annoyance with HAES is that they’ll only find the weight loss to be concerning. Let’s not dig deeper to see if too much weight gain can be due to health concerns or cause a baby to be born too early / miscarry.
*And I also agree with everyone saying that expecting mothers are vulnerable and the conversation needs to be gentile in this approach, for sure. But doctors aren’t therapists and you can’t always blame them for having a straightforward approach. They literally spent 12 years of their life studying the human body from a scientific lens.
Hi Lauren – I can see your point here with that we cannot just ignore other potential medical diagnoses and be ignorant. Having discussion with patients is absolutely necessary so they are getting the best care possible. Unexplained weight gain or loss I think certainly would warrant further exploration but that would take having a conversation about habits/behaviors to determine if it was unexplained. If disregarding further exploration of unexplained weight gain was a message HAES supported (which is almost always accompanied by other symptoms too) I wouldn’t be in favor of that either. Thats not one of the principles but I can see how that could be a portrayed message since HAES has gained a lot of traction in recent years. Thanks for commenting and reading!
Hi Robyn,
I’ve followed your blog for a while and appreciate the message you are trying to send of HAES. That being said I was a little disappointed by your Lululemon ‘rant’. I agree, my size is definitely larger at Lululemon than some other stores but I have grown to be okay with that because my pant size definitely doesn’t define me. I also don’t believe Lulu is specifically making their clothes tiny, but many other stores have adjusted their metrics so people can fit into smaller sizes. There has been a huge rise in vanity sizing (http://time.com/how-to-fix-vanity-sizing/) over the years and I’m kind of glad Lulu isn’t a part of it. Would it be nice for Lulu to make a wider range of sizes to be more inclusive, definitely, but I don’t think they should adjust their sizing metrics to try and make women feel better about themselves.. Also, if you browse their website or go into their stores you will see that not everyone employed by Lulu is a super fit person with a flat stomach. This link is of a model who you can tell is in good shape but has a booty and Lulu isn’t afraid to show it! https://shop.lululemon.com/p/women-crops/Time-To-Sweat-Crop-MD/_/prod8900950?color=32589
This is what turned me away from Lululemon
https://www.huffingtonpost.ca/2013/11/06/lululemon-chip-wilson-womens-bodies_n_4228113.html
Hi Natalie! Thanks for sharing your own experience that has been quite different. I will certainly check out these links. For me, I think I’ve gotten a lot of different messaging that has had a different impact on me. And I agree with you that many stores have adjusted their sizes – such is life. In my experience, I’ve felt they have made clothes smaller so only small bodies can wear them. My experience is certainly not everyone’s! Certainly there are diverse bodies on Lulu’s site, but I would love to see women of all sizes, especially women who aren’t by society considered “in good shape” be able to model their clothes – I realize these are probably unrealistic and high expectations for a fitness clothing brand but a girl can dream! Thanks for sharing your perspective!
Robyn, vanity sizing means listing a size 0 or 2 but actually having it fit someone who is a size 4 or 6. Vanity sizing is the opposite of what Lululemon does.
thanks for clearing that up Margie!
I’m with you on Lululemon, Robyn! I wore their clothes for YEARS, until their fabric quality started to go downhill and I wasn’t getting my money’s worth anymore. Since switching to Athleta, I’ve noticed Lulu has a very long way to go as far as representing all body sizes on their website. People act like it’s this big hurdle to overcome but there are brands who are already doing it beautifully (like Athleta). American Eagle/Aerie are also lightyears ahead (quality of their undies/bras is great too). The idea that clothes look “best” on very thin bodies is just…outdated, ridiculous, and subjective. When I buy something online, I like seeing how it might actually look on me! (a 5’1 girl with hips and thighs. Literally most of those models have legs up to my nose lol).
I thought this was a great post. I’ll put in my two cents here since I saw my name. I was open with my OB about having had an eating disorder and how it wouldn’t be healthy for me to know my weight every month or week. So I requested that my weight not be brought up in appointments unless she was concerned about something. I did have to remind the nurse at every session to not say my weight out loud and then my OB would write my weight on a piece of paper I had to check out with so I just learned I didn’t need to look at that paper. Some people can see their weight and it’s no issue, but knowing my weight never helped me take care of myself better. I did say to my OB (and do believe STRONGLY) that our bodies know how to gain weight in pregnancy and that is not just a nice thought.
A focus on healthful behaviors, rather than a focus on weight gain, IS still a focus on health. IMO after delivering my baby I realized that our bodies know how to grow and push out a baby (my body just took over in labor and I was along for the ride), just like my body gained however much weight it needed to in pregnancy and I was along for the ride. It’s no different than a sneeze or an orgasm…your body just takes over.
It is diet culture that makes us think we can’t trust out bodies. OB’s are wonderful for being able to catch the occasional times when our bodies aren’t working properly…like a thyroid issue.
I also requested not to see my weight-or discuss it-at appointments. If weight is a concern at appointments, why does it need to be reported to the patient? Couldn’t a doctor say, I see some measurements that are atypical and want to ask some questions and run some tests to rule things out? Then IF they patient wants more information (i.e. the numbers) they could have a thoughtful discussion. To me, weekly and monthly weigh ins in which the patient is made aware of the numbers cause unnecessary stress and don’t look at the whole picture (patterns that emerge throughout the pregnancy).
Thanks for your input Kylie and adding your own experience! And of course I’ll echo you, there are always going to be pathological findings that some people experience. Like thyroid issues for example that should definitely be considered but don’t apply to everyone – nothing is black and white.
I agree with both sides here. Medically I can under why a provider would want to measure and assess weight gain in pregnancy to make sure it isn’t so much that complications arise. However there is a kind way to do this versus just a cold regurgitation of facts and numbers to the patient.
My friend found out she had gestational diabetes and went home and cried and ate a pint of ice cream. When she called me later she said she has been binge and stress eating because she and her parter had been having a lot of problems and this had been a surprise pregnancy and she was stressed about finances among a million other things. So perfect example of finding out what’s going on behind the scenes of weight gain in pregnancy.
Also it’s a nice reminder to be nicer to each other as women at any stage of our lives. Another close friend has had two healthy babies and because of her natural body type ( she’s 5’1″ and has a naturally short torso) literally everyone was constantly telling her how “huge she looked” and the old “you’re sure I isn’t twins” thing. It’s just how her body holds a pregnancy. She also had a lot of swelling in her face, etc. She really felt very bad everytime someone commented on how huge they thought she was. But she was healthy and it would have been much more reassuring to hear a positive comment. Even it it was the cheesy old “you’re glowing” kind.
It’s certainly a delicate dance! Weight can be one value available that can help HCPs ask more questions, but I think it’s sometimes taken “at face value” if that makes sense. And thanks for sharing these experiences with people you know to further drive home the point that everyone’s body is so different!
Hi Robyn! YES to everything you said regarding postpartum bodies. This might be long but I am sharing for others to hear a real life experience: I am 15 months postpartum and let me tell you, my body has been on quite the journey since getting that first positive test in Mary 2016. I was very thankful that my doctors never said a word about my weight gain, even when I gained well past the recommended 30lbs (try, double that…) and I never worried about it. I never worried because first, after working with you I have changed so much, but also because I knew I was honoring my body’s needs throughout my pregnancy. I worked out but in different forms, in whatever way felt good for my body at that time. And I ate pretty on par with my usual but I didn’t focus on details. I ate what sounded good. Example: my two biggest and consistent cravings were: egg and cheese sandwiches, and apples. NEEDED a cold apple every single day. NEEDED and egg & cheese sandwich every evening after work (and before dinner 🙂 ). But, I was also STARVING in my first trimester and let me tell you, there is no denying that hunger. I mean I would wake up at 1 AM and need a snack before I could go back to sleep. I firmly believe you must must must listen and honor your body’s needs (all the time but also…) when pregnant.
So fast forward to post-delivery: that crap about being about to jump back into workouts after 6 weeks is just that: crap! You are NOT healed internally to start jumping and bouncing all around! Maybe healed enough but not entirely. I was 4 months pp before I tried to run again and my bladder tap-danced the entire time (and I had a normal vaginal delivery with nearly no tearing). Also, there is such a lack of sleep for many many months in the first year of your baby’s life and as you always say, you NEED rest. Without it, exercise will create negative stress…and at a time when your hormones are still not 100% you just don’t need that. Of course everyone is different but the problem is the comparison trap in our social media obsessed society. A new mom may have a sleeping baby on her chest, scroll through Instagram and see another new mom in a crop top talking about working out during nap time and the scrolling mom could instantly feel so bad about herself. There isn’t a realistic portrayal of pospartum in social media.
Beyond all of that, I firmly believe our focus should be on postpartum MENTAL health. My goodness…the hormones, the experience of your whole world changing (sounds dramatic but it’s very true), the anxiety that can creep up and/or depression…it is SO normal but still so not talked about the way your “post-baby bod” is and that is sad. I thought it was ridiculous that people were so worried about when I was having time to “get back into the gym” post baby but to me, that was the last thing I cared about. Instead I needed help processing all the changes in my life and the anxiety that came with it.
So to the new moms and soon to be moms: your are normal for wanting to focus on your baby, on resting, on your family, on staying home and letting your sweet newborn nap on your chest, on trying to figure out who you are now that you’re a mom…this season is just that, a season. This first year of your child’s life will move so fast and before you know it you will have a little more time in your days and weeks to squeeze in some exercise time (for the endorphins!) and your body will feel more healed in time. Just do what YOU need today. In this moment. To be in a good place for yourself and your family. Life won’t look the same as it did pre-baby but you will find a new normal and a new flow eventually. Give yourself grace. <3
YES TO ALL OF THIS!!
I am no where near having children, but if I ever am pregnant, I am going to come back and read your comment, Calla!! So much great stuff in here. Glad you shared.
Thanks for sharing Calla!! I know it will be just what some readers need to hear today so thanks for being vulnerable and encouraging!
Oooo I love Kylie’s response back to her OB. I’ve had some jab-worthy yet well intended comments made to me, but I am so grateful I was in a place of high self-assurance that her comment rolled right off my back. Praying HAES and just plain ole body-respect finds itself into scientific literature more frequently.
Hi Robyn!
Thanks for this post. I have to just chime in and echo Kylie above and those words “my body knows how much weight to gain in pregnancy.” It just does. I’m 8 months now and even at the beginning- like, a month or two in- I had already gained 10 pounds. I don’t have thyroid problems. Propel water was literally a food group at that point and I was so sick that I would walk away from dinner most nights having had a few bites. Despite that, the baby is in the 90th-plus percentile for weight and size. I do not have GD. My labs are fine. My wedding rings instantly didn’t fit from swelling and my shoes were tight a couple months in. It’s how my body handles this life doing its thing in my belly.
When my doctor brought up how much weight I’ve gained, she started with– “How is your hunger?” Rather than, “You’ve gained too much.” She has taken the time to talk with me about my family history (my mom’s weight gain, which was at like 60 pounds despite working, being active and living and walking in a city, and having 9 months of nausea suppressing her appetite like me), my AND my husband’s family history of babies over 9 pounds (5/6 siblings between us, with one 10 pounder and one 11 pounder). She gently suggested that a lot of factors could be playing into my weight gain, and just wants the baby to be healthy and for me to have a safe delivery. That, to me, is a much gentler way to look at the whole pregnant person and ask about the myriad of factors playing into her weight gain. I TRULY do not feel like I have control over this. We always joke that our little man is in the pilot seat.
There are SO many factors at play in why women gain weight in pregnancy, and while I STILL didn’t like to talk about it (history of controlling eating habits and over-excersizing finally kicked a couple years ago), I appreciate this sort of behavior and medical history-type approach rather than assuming I’m putting down brownies for every meal. I’m not. In fact, I can still barely stomach food at all many days.
Pregnant women have it tough. I either have people saying I look like I’m going to go any day or who don’t even notice/realize I’m pregnant, and it literally depends on the day, how much I may have bloated or retained, and my outfit. Everyone has something to say about their bodies, their weight gain– too much! too little!– bump is too big, too little, too much/not enough exercise, forgetting that they’re addressing an exhausted, anxious, and probably aching mom-to-be. Approaching the whole person makes a difference in how we are going to respond to care. It’s not coddling to delve a little deeper and find out what’s going on. If my doctor had straight up said, “gain less weight,” I would have found alternate care that day.
Just speaking from experience and have no medical background at all. I am amazed at my body, care for it lovingly, move it when I’m not in pain, give it as many plants as I can (usually in smoothie form), and am doing my best to keep my mind in a non-anxious place as so much changes in my body. I think that’s where a lot of pregnant women land.
Hi Melissa – thank you so much for sharing the experience you’ve had with your doctor! I think it illustrates a gentler, softer approach that like many commenters have mentioned, takes into consideration a woman’s vulnerability and the multiple factors that play into her health. So glad you’ve found a wonderful OB! So well written, thank you!
Check out Girlfriend Collective for yoga pants! They are SUPER sturdy because they are made of recycled water bottles. AND their website is full of beautiful women of all shapes and sizes. I just got my first shirt from them and it is crazy soft. Love their goals all the way around.
I’ll have to – thanks!!
Yes! I was going to suggest the same.
Robyn, I really appreciate this! I know many women who, while pregnant, were criticized for gaining an extra 2 or 3 or 5 pounds above the “expected” range. It seems like many OBs attempt to micromanage this aspect of pregnancy, and it’s just not realistic.
Also, regarding pregnancy weight gain… I gained quite a bit of weight while pregnant, but I think some of it was good. If my set point is X weight, I was killing myself to maintain my weight at X-20. So when I got pregnant, I gained weight that probably should have been there in the first place, AND gained weight due to being pregnant. I had been starving myself for 3 years, and pregnancy was finally an excuse to eat freely. On paper, I gained about double what I “should have”, but I don’t think that would have been the case if I had developed healthy eating patterns before becoming pregnant.
Such an important part of this conversation – thanks for sharing Korie!!
So interesting to read your post and the ensuing comments. As a medical provider I do think any discussions about weight need to be approached thoughtfully. I’m pregnant with my 2nd baby and still vividly remember my 32 week appointment when I was pregnant with my first baby where the OB (not my usual doctor) talked to me about “being more careful” with my weight gain and said that I was gaining a little more than was advised. I still wonder what she was thinking, as it was a textbook pregnancy and I ultimately gained 32lbs. If she would have inquired about my habits first, she would have known that I ate very nutritiously throughout, did some Pilates when I felt able and (up until then) had felt great about the way I was caring for myself and baby. I remember sobbing in the parking lot after that visit and the following 7 weeks would find myself thinking, “are you really hungry?” “Maybe you should just have something smaller/lighter/less caloric” type thoughts that really took away a lot of the enjoyment of the remainder of my pregnancy. I’m determined not to have that experience this time around!
Whenever people talk about getting their body back, I think “Where did your body go? Mine’s been here doing some insane stuff the whole time!” I hate how our culture seems to think that female bodies are supposed to remain in their 20s state for a lifetime. I know that even if my body didn’t do the work of growing/nourishing babies, it STILL wouldn’t remain the same and it shouldn’t!
Thanks for replying Jen as another medical provider and someone who has been on the other side as a patient. I agree with you – and like the other medical providers who have commented – I think we all agree that the issue at hand is having sensitive, thoughtful conversations if a medical provider is concerned that a mother’s weight will lead to complications. Thanks for reading!
I’ve never commented before, although I’ve read your work for a long time, Robyn. I really appreciate how hard you work and how passionately you share your beliefs. I also really appreciate the supportive, respectful discussion here and hope very much that my comment is also supportive and respectful.
All that said, I have to respectfully share that your description of your friend’s comment to her doctor struck a wrong note with me like nothing I’ve ever read on your website before. I’m guessing that your friend was well informed, having a pregnancy she believed to be normal and had gained what she knew, thanks to her research, was a normal amount of weight. I’m also guessing that her intention was to gently and firmly end a discussion which she felt was inappropriate. However I feel that, taken out of context, her comment could be perceived as not only arrogant (even if that wasn’t how it was meant it did come across that way to me, no offence meant to your friend) but also, as an example to other women, misleading and dangerous. As previous commenters have said, a woman’s body doesn’t always know how much weight to put on to grow a healthy baby. Imagine if a woman who was gaining a dangerous amount of weight had that attitude, ignored her doctor because “my body knows how much weight to put on”, and put her health and that of her baby in jeopardy! Not everybody is intelligent and well-informed.
I think that that’s the main issue I have with HAES – it’s a fact that being either very underweight or very overweight just isn’t healthy, and it could be argued that it’s irresponsible to promulgate the message that you can be healthy at every size. I’m not very well-read in HAES and I’m not even sure if that is the message, and I’m certainly sure that there are important nuances to the HAES message that I’m missing, but I do wonder if that is a problem in itself – is the headline a damaging message even if the nuances aren’t? I’d love to hear your thoughts on whether HAES could potentially be heard by women who are either very under or very overweight as justification, and if so how the movement attempts to mitigate this. I do think that the movement is saying so many important things so I’d be really interested in learning more about what I perceive as a potential problem for the movement.
Once again I hope that this comment is supportive and respectful of you and of the women who have made fantastic points in the comments.
it may well be that I’m missing important nuances, which is why I’m commenting really – I’d be grateful if you could educate me!
Hi Liz! thanks for your comment and discussion here. The comment could have used more context – yes. Kylie commented in this thread which I hope sheds some more light. Here is a link to read more on HAES. https://www.sizediversityandhealth.org/content.asp?id=76
HAES is in no way saying everyone is healthy at any and all sizes. Not at all. There are certainly high and low weights that are not healthy for a person’s body and those exact numbers will differ from person to person. I’m simplifying HAES here for the sake of this comment, but HAES is taking the focus off of exact numbers and instead says, “let’s focus on health promoting behaviors and getting people to change behaviors that would improve their health” This decreases shame and increases self esteem and self efficacy – all important when making healthy changes for your life. The concern is still health but it takes the focus off of weight which is an outcome. I hope that helps some and I hope the link is helpful!
Love this post Robyn. And your insight to the discussion around pregnancy weight gain. Being 15 months postpartum, I’m JUST now coming out of the fog of obsessing about my pregnancy/postpartum weight. And let me tell you, my worrying and obsession over being “healthy” (aka not gaining “too much” weight) while pregnant led me to being far more unhealthy overall. I was only basing “health” by the weight gain, and yes, while it is an indicator, it isn’t everything. And living under the pressure and cultural expectation to stay “healthy” I put my all into not gaining too much and losing it as quick as possible…and I only ended up far unhealthier, living from weigh in to weigh in, and basing my value on what the scale said, obsessed with food and not eating too much,, and feeling incredibly guilty and negative about my body. On paper, my pregnancy was picture perfect because I met the cultural desires/expectations….but emotionally and mentally I was a wreck from the pressure of diet culture. Instead of resting, healing, and enjoying the first months with my babe, I put my body through so much stress due to a frantic effort to get my “pre baby body” back. Feeling so much pressure and obsession to get that body back that it was occupying just as much of my brain as trying to care for my babe was NOT healthy. Much of that is on me and due to my choices and struggles, but I do think it would have been much easier if the pressure from our culture and some medical providers wasn’t so high. I SO wish I would have had a better picture what what truly being healthy during pregnancy means. It is so much more than one measurement. And I so wish i had had a healthcare provider who was aware and thinking of the whole person behind the numbers. I hope to have more kids and am excited to have entirely different goals of what it means to be healthy in pregnancy. Thank you for you writing about this and the work you do! It is so, so, so, helpful.
Thank you for sharing your comment Katie and I hope you have the experience you are hoping for with future pregnancies. <3 Thank you for reading!
I appreciated this post. I’m 17 weeks pregnant and with my ED background, very aware of the weight gain. I asked my doctor not to discuss my weight unless it was an issue, but I’m not quite at Kylie’s trust of her body (although I’m trying to work on it). Hearing other perspectives is healthy for me – even my pregnancy books focus on eating what’s “best” when I need to be focusing on what my body is telling me.
My roommate and I were just talking about that driving across states thing the other day. She’s from the Boston area, and I’m from Kansas, and our relative perceptions of driving distance are really different. So are our perceptions of population density and traffic. I’ll bet having grown up in the Midwest and then lived in New York and Boston that you can imagine what our conversations are like.
I think if you’re feeding yourself with nutrient-dense foods daily while still enjoying a treat here and there while being pregnant that is completely fine AND that should be the main focus instead of weight. I remember every time I would go in for my checks, I would get nervous about the “weight gain” because I was always on the “high end” of the weight gain (mind you I got my pregnant at a pretty low body weight for my height) and I always tried to explain to the OB that I was making good food choices and it was probably just all that nut butter & avocados 🙂
Thanks for sharing Katie! My goal in the post was to say, “I really wish we’d focus more on behaviors with pregnant women instead of the number itself” I’m not saying throw the baby out with the bathwater of course, but I think if a doctor is monitoring labs and vital signs and all looks healthy and mom is eating nutritiously and moving her body and getting good sleep and caring for herself emotionally – that would be a more helpful way to go about monitoring a mother’s health vs seeing weight as the bottom line. Again, not throwing the baby out with the bathwater – I just think we have blanket recommendations that might not apply to every woman’s body when she is caring for her health the best way possible. Thanks for your input Katie!
Great discussion! I would also caution against comparing the management of weight for overall health the same as monitoring pregnancy weight gain for maternal and fetal health. Apples and oranges. Yes, In both cases focusing on health should be the goal, but there is literature that supports monitoring pregnancy weight and known risk associated with excessive weight gain during pregnancy. I know one of your biggest issues with BMI and obesity as it relates to health outcomes is lack of research, but in pregnancy that isn’t necessarily the case. With great respect, I think you are speaking a little too confidently on an issue that’s a little outside the scope of HAES.
Hi Rebekah! I’m not throwing the baby out with the bathwater here. Not every person is healthy at any size, there are certainly weights (high and low) that would not be appropriate for a person’s body – pregnant or not – and HAES isn’t saying be whatever weight you feel like being. But I think we can’t take blanket recommendations and apply them to every single pregnant woman. There are so many factors that would determine mom and baby’s health – labs, vital signs, behaviors etc. Weight can be a measure that the HCP has in addition to many other pieces of information to inform decisions and recommendations but what I’m saying is that I think it gets way too much of a focus and is seen as the bottom line and then other really important factors are discussed enough. From the post “your health care provider’s job is to care for you medically and guide you toward behaviors that keep you and your baby as healthy as possible” Thanks for adding to this conversation and for reading!!
Abslolutly LOVE LOVE LOVE this blog & all that you have to say Robyn!! I’ve learned so much from you but my one problem with HAES is that it seems to almost assume at times that most people eat intuitively. In the perfect world where everyone ate intuitively I think that women’s bodies would know the right amount of weight to gain for the baby. The problem is that A LOT of people don’t eat intuitively. When I was pregnant with my first I went had been in the binge-restrict cycle for so long that pregnancy was a great excuse to binge. Talking behaviors with my doctor wouldn’t have helped that much because I’ve always been great at including fruits & vegetables and by nature I’m someone that loves to move & exercised thoughout the pregnancy. But for me pregnancy was also an excuse to overdo it on all the “forbidden” foods because I was pregnant LOL (: In general it makes it hard for doctors to know which side people fall on. There are a lot of people with poor relationships to food & also a lot of people who just don’t take that good of care of themselves so it seems like it could be really hard for doctors to know why there is is excessive weight gain & it would be easy to assume that overdoing it on food could be a very real possibility.
Thanks for the yoga podcast recommendation! I hadn’t thought of podcasts for yoga & am always looking for free at home ways to practice. If you like videos as well, the Journey Junkie has some great shorter yoga flows on Youtube that I’ve really enjoyed. Also she’s always somewhere in the caribbean — a girl can dream! 🙂
You and Kylie are SUCH an amazing duo, and I love how you play off of each other and share your thoughts on so many different aspects of body image. I really appreciate you Robyn and your sweet gentle thoughts about pre baby and post baby bodies, and I think so many moms would be encouraged by this.
Love this train of thoughts. The veering into and out of lanes. I too have wondered how in the world the “ nod of approval” from highly educated individuals has drank the koolaid in thinking you-can” eat what you want to eat, and be true to your size and let your body be your body”.. a unhealthy notion/ justification thinking giving license to eat anything you want and not realize the ramifications. Being 62 my metabolism has slowed way down.,… not my workouts. My eating is with intention. My post partum body was grateful for doing the beautiful job of growing 3 babes- and once done my body needed good healthy foods and lifestyle. The notion of eating all these foods that are fried- heavy laden ice- cream- donuts and such / etc…… has me thinking that educateing oneself is utmost important as to Diabetes- Cardiac Issues- obesity and Bone Health…. truly the list goes on for those who do not realize in their younger years that what you eat( overeat), can and will cost you. I have not seen much talk in these areas here. It is a balance with “ life”, yet over indulging with these foods seems to me a harmful path. I as well believe that our children adopt what we eat….they are watching us, and sadly our society is overweight. Being overweight and yearly weight gain has harming effects.
I came to the blog early on and enjoyed the healthy food- food style and good food talks. Thank you for the past ( early- blog) good words. Take care.
Hi Robyn! I love this blog. I listened to the podcast you linked above and I loved it. The idea of IE and HAES is rather new to me, and it is so radically different from everything I have ever been told before, that I can tell there will be a bit of a learning curve before I understand the nuance and the way for ME to balance my health by eating intuitively. What a beautiful, freeing and self-affirming complete paradigm shift. I’m excited to read the resources you mentioned and continue educating myself about taking care of my body.
Thank you so much for what you do. You offer a voice that runs counter to the prevailing wisdom in our society, and as such, I know you encounter quite a bit of resistance. What you offer, though, literally saves lives by teaching empowerment. That’s not dramatic — I was suicidal three years ago, largely due to body hatred and it’s through accepting the notion that my body is OK that my life has been changed. You give me hope that I can have body freedom someday and that I have the tools to take care of my body and thrive at my weight set point!
Love your blog, keep it up.