Guidelines for Weight Management During Pregnancy and Postpartum: The Formation, Prevention, and Safe Exercise Strategies of Reproductive Obesity

During pregnancy, changes in the function of the hypothalamus lead to increased metabolism and an imbalance in fat metabolism, making women prone to fat deposition and resulting in significant weight gain. After childbirth, a series of changes in endocrine and metabolic processes, increased nutrient intake, and decreased physical activity often lead to obesity. Postpartum obesity, where a woman's weight exceeds the normal range by 20% to 50%, is medically termed postpartum obesity. Women with postpartum obesity often experience loss of appetite, weakness in the limbs, slow recovery of the reproductive organs, and in severe cases, urinary incontinence, retroverted uterus, or uterine prolapse.

To prevent postpartum obesity, it's important to maintain a balanced diet, combining whole grains and refined grains, and avoiding excessive supplementation while meeting the needs of both mother and baby. Eat plenty of fish, shrimp, eggs, soy products, and fresh fruits and vegetables, while minimizing consumption of sweets, fried foods, fatty meats, and other high-fat and high-sugar foods. Regular exercise during pregnancy and postpartum is crucial for preventing postpartum obesity. Mothers who have given birth naturally can get out of bed and move around 24 hours postpartum unless there are complications. Starting from the second day postpartum, light exercises such as head lifting, arm stretching, and leg raising can be done in bed to strengthen muscles and prevent abdominal muscle relaxation.

Breastfeeding not only meets the needs of infant growth and development but also benefits the mother's health and appearance. Studies have found that breastfeeding promotes maternal metabolism and nutrient circulation, and can also transport excess nutrients out of the body, reducing subcutaneous fat accumulation. With China's economic development, the incidence of obesity has risen significantly in recent years, and the incidence rate among women of childbearing age has also gradually increased. For weight assessment during pregnancy, the standards signed by the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics in 1997 are recommended.

For women with a pre-pregnancy BMI between 19.8 and 26, a weight gain during pregnancy should ideally be between 11.5 and 16 kg; for obese women with a pre-pregnancy BMI greater than 29, the weight gain should be controlled to 6 to 7 kg. During a normal pregnancy, due to increased fetal weight, blood volume, and the enlargement of the uterus and breasts, the average total weight gain is about 12 kg. Some women hold the misconception that "the more you eat and the fatter you get, the better," and frequently consume sugary or high-fat foods, resulting in significant weight gain for themselves while their babies are underweight. More seriously, excessive weight puts a burden on organs, and the incidence of diabetes and hypertension is significantly higher than in people with normal weight.

To prevent pregnancy obesity, it's necessary to appropriately limit fat intake, especially in the last three months. A pregnant woman's weight typically increases by 1 to 1.5 kilograms in the first three months of pregnancy, and then by 300 to 400 grams per week thereafter. If weight gain is found to be excessive, it's important to actively adjust one's diet and appropriately increase physical activity, such as taking a walk for about an hour after meals each day. In January 2002, American gynecologists and obstetricians jointly issued a statement encouraging most pregnant women to exercise. Exercise during pregnancy can strengthen and regulate the muscles of the waist, back, hips, and thighs, and reduce lower back muscle soreness.

Exercise promotes the release of synovial fluid from joints, preventing joint damage; it also stimulates the brain to secrete hormones, accelerates blood flow, and gives the face a radiant glow. Furthermore, it increases intestinal motility, reduces constipation, improves sleep quality at night, and prepares the body for childbirth. Good cardiac function and muscle strength preparation make the delivery process easier. Exercise in early pregnancy does not increase the risk of spontaneous abortion or birth defects. Studies show that women who exercise regularly have a lower rate of cesarean section.

Jogging and swimming are the most common and least injury-prone forms of exercise during pregnancy. Brisk walking and stationary cycling are also good choices. For improving flexibility, yoga and body shaping exercises are highly recommended. Pregnant women should avoid strenuous strength training and sit-ups during the first trimester, especially those with a risk of miscarriage. Weightlifting can reduce blood flow to the uterus and lower fetal oxygen levels. Jumping, collisions, sudden turns, or activities that may pose a risk of abdominal injury, such as skiing, diving, and horseback riding, should be avoided. Some doctors recommend avoiding cycling after the sixth month of pregnancy to prevent falls.