Clinicians say there is limited clinical guidance for how to help people lose weight after pregnancy

(Boston)—About half of pregnant people in the U.S. gain excessive weight during pregnancy or retain excessive weight during the year after pregnancy, leading to obesity. Obesity is a risk factor for diabetes, high blood pressure and heart disease. Losing weight between pregnancies can improve pregnancy outcomes and may lower a person's risk for future chronic diseases. However, little is known about how to best help people lose weight after pregnancy.

Now a new study finds that few recommendations exist and they are based on limited data.

“While many people gain excessive weight during pregnancy or are unable to return to a healthy weight after pregnancy, little is known about how to support weight loss after pregnancy,” said corresponding author Mara Murray Horwitz, MD, assistant professor of medicine at Boston University School of Medicine.

The researchers reviewed clinical guidelines or recommendations from 2010- 2020 with information on how to manage excessive pregnancy-related weight gain or postpartum weight retention in a primary care setting. “Overall, the recommendations emphasized weight loss via diet and exercise. However, the best ways to support weight loss postpartum are not really known. They also recommend heart disease risk screening (followed by individualized counseling and treatment, as needed), and talking with patients about ways to improve their health in future pregnancies,” said Murray Horwitz, who is also a physician at Boston Medical Center.

According to the researchers, individuals with excessive pregnancy-related weight gain or postpartum weight retention should be informed about the importance of weight loss to improve their own health and the health of any future pregnancies. “The most effective ways to support weight loss are unknown, but likely include diet and exercise, so these activities should be encouraged and supported. In addition, people with excessive pregnancy-related weight gain or postpartum weight retention might be at increased risk for heart disease, so it is reasonable to consider screening them for heart disease risk factors (e.g., high blood pressure, diabetes) with follow-up counseling and treatment as needed,” she added.

Since pregnancy and the postpartum period involve profound changes to the body, which can have lasting effects on our health, the researchers hope that we can learn to provide people with better care during and after pregnancy, so that they emerge even healthier than they were before. “Finding ways to support people in keeping or returning to a healthy weight during these reproductive experiences is important for obesity prevention.”

These findings appear online in Journal of General Internal Medicine.