I'll admit, with my first pregnancy I got a little buthurt when my OB said I was gaining too much weight too fast.  I told him I was eating a good balanced diet with veggies and fruit.  He told me to cut back on how much I was eating (which wasn't much, about the same as if I weren't pregnant).  He also told me to stop eating fruit. What?  Because of the sugar.  But I thought some natural sugar was alright.  IDK.  He was kind of weird in the first place.  He dressed up for Halloween to deliver my baby.  

Do whatever feels right, I gained 40 pounds the first time around and I was 130 lbs to start and about 5'6''.  I do agree with the exercise.  Just take a walk for 30 min a day.  I'm thinking about taking a prenatal yoga class.  Don't worry, I know there are pregnancy nutrition websites out there, I just can't think of them right now.  You can get an idea of a daily menu from there.  GL. 

They're likely telling you to watch the carbohydrates because they're concerned about gestational diabetes. A "balanced diet" doesn't mean crap, so to speak, if your body isn't processing sugar correctly - tho I do think that they should just give you a 1hr glucose screen if they're really concerned about it. Keep eating your plants - but watch sucrose and starch... mainly, don't eat things with added sugar, don't eat white breads, don't drink juice/soda, don't eat too many corn products, etc. The only carbohydrates your body is really going to benefit from are those found in greens, dairy, and whole grains (fibre and minimal sugars) - the sugar and starch in just about all other breads/pastas/cereals/fruits are rarely, if ever, justified by the nutrition they contain. 

Everything else is normal (BP, etc) and I've got my glucose test next visit.  I should add that my first preg was a breeze, I had mild anemia but that's it.  Gained about 30lb total and gave birth to a 7.5lb baby girl in 2008.  It was with a different practice, but they never said boo about my weight gain.  I just feel like I'm in a normal range, so why are their comments making me feel like ***?

Remember, doctors aren't nutritionists. They know the guidelines for weight gain but they aren't experts on healthy eating necessarily.

The accepted standard for normal BMI is 25-35 but I think most doctors SAY 25, thinking that if they tell women 35 then they'll gain even more. So if they say 25 and you gain 30 then they've had more luck keeping your gain under control. Does that make sense?

My doctor told me 25 last time, too, and I'm normall 5'2" 110-115 lbs. I gained 30 by 36 weeks and they were fine with that. (I delivered early.)

 This time I'm gaining a little faster but they don't seem concerned. I'm up 16/17 at 26 weeks. Just do the best you can.

I don't think you should be outraged at your doctors: if 2 different doctors have said the same thing just try to be mindful but not obsessive about your diet. Counting calories can be a very inexact science and a lot of ppl tend to underestimate what they actually eat.  Maybe keeping a food diary and focusing on what you're eating instead of how many calories you're eating is a good idea.  If a Dr. mentions something again, you could ask for a referral to a nutritionist to talk about it: a lot of insurance plans cover a couple health related visits a yr. 

Yes, exercise is important: try some yoga or swimming or just walking.  It will prepare you for the strenuous birth experience and help you feel good about your body as it changes.

Rynleigh:

They're likely telling you to watch the carbohydrates because they're concerned about gestational diabetes. A "balanced diet" doesn't mean crap, so to speak, if your body isn't processing sugar correctly - tho I do think that they should just give you a 1hr glucose screen if they're really concerned about it. Keep eating your plants - but watch sucrose and starch... mainly, don't eat things with added sugar, don't eat white breads, don't drink juice/soda, don't eat too many corn products, etc. The only carbohydrates your body is really going to benefit from are those found in greens, dairy, and whole grains (fibre and minimal sugars) - the sugar and starch in just about all other breads/pastas/cereals/fruits are rarely, if ever, justified by the nutrition they contain. 

100% this.  I'm sure it's hard, given the hormones not to get your feelings hurt.  However, I'm sure your rational mind knows your doctors are not trying to make you feel bad.  They just want you and your baby healthy.  I would focus less on caloric intake and pay more attention to the types of foods you are eating, taking into consideration your doctors request.  I would avoid all processed foods, foods with HFCS, and breads/pastas/cereals and maybe cut down the fruit intake to 1-2 pieces and increase the veggies.  

Bliss+Berry:

Rynleigh:

They're likely telling you to watch the carbohydrates because they're concerned about gestational diabetes. A "balanced diet" doesn't mean crap, so to speak, if your body isn't processing sugar correctly - tho I do think that they should just give you a 1hr glucose screen if they're really concerned about it. Keep eating your plants - but watch sucrose and starch... mainly, don't eat things with added sugar, don't eat white breads, don't drink juice/soda, don't eat too many corn products, etc. The only carbohydrates your body is really going to benefit from are those found in greens, dairy, and whole grains (fibre and minimal sugars) - the sugar and starch in just about all other breads/pastas/cereals/fruits are rarely, if ever, justified by the nutrition they contain. 

100% this.  I'm sure it's hard, given the hormones not to get your feelings hurt.  However, I'm sure your rational mind knows your doctors are not trying to make you feel bad.  They just want you and your baby healthy.  I would focus less on caloric intake and pay more attention to the types of foods you are eating, taking into consideration your doctors request.  I would avoid all processed foods, foods with HFCS, and breads/pastas/cereals and maybe cut down the fruit intake to 1-2 pieces and increase the veggies.  

So I should stop eating muffins then, lol. 

If you're truly eating a healthy balanced diet, then there's not much you can do. Some drs care more about weight gain than others. I gained 60 lbs with my first and all my ob said was "you're young, you're healthy, it's not causing your baby any harm (ie at risk for being bigger) its just going to be harder for you to lose afterwards once you creep over that 40 lb mark" boy was she right. Pending everything else is ok like glucose testing just shrug it off and stay dedicated to being healthy.

AmericnJewl:

I don't know what level of outrage should be applied to this situation...

I'm 5'4" and weighed 130 pre-preg, no exercise to speak of, just a generally healthy diet with occasional indulgences.  At my first appointment the NP said that my BMI is 22 so my target weight gain should be 25lbs. Seemed kinda on the low end, but whatever.

I'm now at a total gain of +16 lbs. But over my last two visits (group practice, so different doctors), I was told to keep an eye on the gain, that they're "a bit concerned" and to "watch the carbs" (again, by two different doctors, same practice).

 

While normally mostly confident and secure, I tend to react poorly, so it just makes me want to eat more.  I've been tracking my caloric intake for the last four days and I've averaged 1,700/day.  This last visit is what got to me... in an attempt to defend myself, I let the Dr. know that I do eat a relatively healthy diet (with vegs/fruits in every meal, etc).  But the "watch the carbs" statement... I don't know, seemed strange. Why wouldn't they have said "strive for a balanced diet with emphasis on fruits and vegetables, or *something.*  They haven't provided me with a caloric or nutrition guideline either.  

Instead, I was told to exercise 5 times/week for 30 minutes.  

Generally, a doctor who says "watch the carbs" doesn't know what he/she is talking about.  What should have been said is "watch the refined carbs."  Fruits and veggies are carbs and the doctors want you to eat those.  However, as far as weight gain is concerned, the carbs or lack thereof will not really have much of an effect.  It is how much you eat, not what you eat that causes weight gain.  Your calorie intake sounds good.  I wouldn't worry about the weight.  16 pounds at 24 weeks isn't a bad place to be.  I would, however, take the exercise advise.

Rynleigh:

They're likely telling you to watch the carbohydrates because they're concerned about gestational diabetes. A "balanced diet" doesn't mean crap, so to speak, if your body isn't processing sugar correctly - tho I do think that they should just give you a 1hr glucose screen if they're really concerned about it. Keep eating your plants - but watch sucrose and starch... mainly, don't eat things with added sugar, don't eat white breads, don't drink juice/soda, don't eat too many corn products, etc. The only carbohydrates your body is really going to benefit from are those found in greens, dairy, and whole grains (fibre and minimal sugars) - the sugar and starch in just about all other breads/pastas/cereals/fruits are rarely, if ever, justified by the nutrition they contain. 

this

This can be taken numerous ways.  Maybe I can help understand a bit.  I have PCOS and for me watching my carb intake is very important. Eating healthy doesn't always mean watching calories because you can be eating healthier food but there's more to it than counting calories.  After I finally saw a nutrionist and began to understand what affect carbs truly has on my body did I realize what eating healthy meant for me.  In reality my carb intake need to be between 35-50 carbs a day.  Not very much especially when you consider the amount of carbs in everything.  I realized this when I started paying attention to the dietary description on everything.  The one thing I did learn that might also help you is if you have something for example that has 23g of carbs but has 4 dietary grams of fiber you can subtract the 4 and actuall only be getting 19 grams.  There is something (don't really remember the scientific details behind it) but fiber provides a dietary need that helps subtract the carb intake therfore lowering the total amount of daily carb intake Eating fruits during pregnancy are important especially during pregnancy but here is something to consider, a banana has the highest carb intake of all fruits (almost my daily allowance) so I generally only eat this after running.  Any fruits that are sweeter have higher carb amounts, general rule my nutritionist gave me is basically all tropcial fruit i.e. mangos, pineapple, etc have higher carbs and those more sour are the better ones to eat.  Sorry I know my explanation is long but hopefully some or all of this information will be more helpful to you. 

I think doctors are in a really tough place when mentioning a patient's weight. Some patients will get upset whereas others would prefer to know.  If two different doctors have mentioned it, I would at least try to incorporate some changes. My doctor has told me that many of his patients eat way too much fruit while pregnant and it causes weight gain and makes them higher risk. Even in its natural form, that much sugar isn't healthy.

I'd try upping your veggie and fiber intake and try to cut back on refined carbs and fruits high in sugar/low in carbs. 

Thanks, to everyone that posted (regardless of my reaction to it behind the screen).  In my mind, 'county calories' meant keeping a food journal and being mindful of what I'm consuming (I guess I didn't realize some people just add up the numbers alone).  75% of the carbs are coming from 'healthy' foods like milk (1%), sweet potatoes, or whole grain brown rice/quinoa.  I don't even eat pasta or bread (whole wheat) but *maybe* once a week (plus hubs is on a dietary guideline from his trainer not to eat carbs for dinner (or after). 

I think my frustration came more from the fact that they didn't bother to ask me about my diet or give me more information. And it was only only when I balked about her comment that she tossed out the exercise bit. 

I am 21 weeks pg and have the same weight gain as you and my OB has not said a thing.  I appreciate this because this is my 4th pregnancy and this OB has seen me through the other pregnancies and deliveries.  She knows that I will gain around 40 lbs.  I think your OB should know from your last pg that things will most likely go the same way.  I think he/she has obviously caused stress where they shouldn't have.  1700 calories isn't even enough to maintain your normal, non preg weight so I think you should just go on about your business and eat the way you were before he OB said anything.

AmericnJewl:

Everything else is normal BP, etc and I've got my glucose test next visit. nbsp;I should add that my first preg was a breeze, I had mild anemia but that's it. nbsp;Gained about 30lb total and gave birth to a 7.5lb baby girl in 2008. nbsp;It was with a different practice, but they never said boo about my weight gain. nbsp;I just feel like I'm in a normal range, so why are their comments making me feel like ***?

Lurker here!

My OB made me feel horrible about my weight gain when I gained 5 lbs a month during my monthly visits. She kept telling me to "watch the carbs, and I don't mean as they're on the fork on the way to your mouth!" She also told me to cut out desserts. Um. I don't eat sweets, and hardly ever eat bread or pasta when I'm cooking.

I think she was worried about GD more than anything. I had myself all prepared to have it based on the things she had been saying. I didn't end up having it, and she backed off a bit. Now at my every other week appointments I gained 1 lb. I did gain a large amount this last week I have an appointment on Wednesday and they know about it. I think it's water retention at this point.

Either way, don't stress. If you're doing what you know is right for you, then keep doing it. I'm trying to take my own advise!

I would take the statement with a grain of salt (easier said than done, as I know I would be upset, too). I'm only 5'2" and 130 pre-preg and I was told to gain ~35 lbs, and I'm only 20 weeks and have gained 20. My doctor hasn't said anything negative about my weight gain.

If the doctor wouldn't listen to *what* you're eating, and you're eating healthy, like you say, I would just ignore the comments. You know your body and that you're doing what's right for you. Actually, I would be looking for a new doctor with comments like that that come with no real kind of advice or anything, especially if your doctors won't listen to what you're saying, but that's just how I would over-react in this situation. :)

I really have been so lucky not to have a doctor say anything to me about my weight or my weight gain so far..I think all my other numbers (sugar/protein in urine, BP, HR, etc) all speak for themselves.  

 

I started at 5'3, 123 lbs (with a low BF % due to being highly active)....I am 23w, and will probably be at 17-18lbs gained by 24...so I am very high on the weight gain scale. I have continued to exercise at the very least 5x a week, doing high intensity exercises/weight lifting AND usually walking at least 4 miles 5x a week.  Unless i was waiting 2600-3000 calories a day, there's no way I could have put on that much fat in that short amount of time (I gained 15 of those lbs after 12 weeks).  The weight gain is mostly from fluid retention-I've always been suspectible for retaining more than average, and with the baby i just bloated up and remained there.

at 1700 calories, unless you are a complete sloth, you wouldn't be gaining fat. Considering the fact that most women will burn 1300-1500 calories just existing, add on the extra 200-300 calories for fetal growth due development..you are fine.   

Some OBs seem really concerned about weight gain. Others, like mine, never said a word to me.

I started out at 5'4" and 135 lbs with DD1 and gained 60 lbs. (She was born 10 days late...) My OB never once mentioned anything negative about my weight gain. I'm not even sure she told me a target amount, now that I think about it. I know she didn't this time, and I started out almost 20 lbs overweight.

I think that every women gains weight differently in pregnancy. Some women are going to gain more just because of how their body reacts to the hormone changes. 1700 calories is on the lower side too. That's about how much I ate when I was actively trying to lose weight.

So, like I said, I started out 20 lbs overweight this time. I have continued to work out 3-4 days/week. I spend 45 minutes weight lifting 3 days/week and 30 minutes doing cardio 2-3 days/week. I am almost 19 weeks and am up 10 lbs now. I have an appointment tonight, and my weight gain over the last 4 weeks has been about 4 lbs. I guarantee the only thing my OB will say is that my weight gain is fine. My personal goal is to stay between 30-35 lbs total.

AmericnJewl:

Everything else is normal (BP, etc) and I've got my glucose test next visit.  I should add that my first preg was a breeze, I had mild anemia but that's it.  Gained about 30lb total and gave birth to a 7.5lb baby girl in 2008.  It was with a different practice, but they never said boo about my weight gain.  I just feel like I'm in a normal range, so why are their comments making me feel like ***?

See, with this in mind, I would ignore the weight gain comments. If you didn't have any trouble with gestational diabetes in the past, and you're eating similarly to what you did before, then you're probably at low risk anyway. But I also tend to think that doctors don't know everything, and I prefer to do my own research and make my own informed decisions.

AmericnJewl:

I think my frustration came more from the fact that they didn't bother to ask me about my diet or give me more information. And it was only only when I balked about her comment that she tossed out the exercise bit. 

This would bother me too and really cause me to lose confidence in their medical advice. If they really are concerned with your weight gain (your specific weight gain, not a woman this size should gain this much generic crap), they should have worked with you on figuring out what in your diet was causing the extra gain.

 

::lurking::

Unless you have risk factors for GD or something that seems like a huge overreaction on your doctor's part.  Maybe if a lot of the weight came at once I can see them mentioning it, but I tended to gain weight in spurts my first pregnancy anyway.  I started out at 138 and gained like 45 lbs.  I was healthy, active, and when I got hungry I ate good calories.  I was just genuinely hungry a lot.  My OB wasn't concerned in the slightest and I lost all the baby weight within maybe 6 months or so.

Obviously eat good food, and a few walks or some swimming might be a good idea, but I would take this with a grain of salt personally.  All doctors are different but all you can do is the best you can to have a healthy pregnancy.  Don't freak out about a few extra lbs.

And really the rate you're gaining at isn't even "extra".

 

I wouldn't feel any outrage over this. Obviously if two doctors are a bit concerned about your weight, they have a reason. You're supposed to gain about a pound a week in the last 20 weeks or so, so where you're at if you keep gaining steadily, that will put you at a 32 lb gain... which isn't awful, but there's really no need to gain any more than you have to.

I mentioned to my doctor that I was concerned I was gaining weight too quickly (up 9 lbs at 17 weeks). She suggested that I could cut back on carbs, but said I should NOT try to count calories or restrict my calories. She said any kind of calorie restriction is not healthy for baby or me, but that cutting back on carbs was positive all around. In addition to preventing excess weight gain, she said that this can also help cut my risk of gestational diabetes. (I was not overweight pre-pregnancy, but I was somewhat close with a BMI of 24.5 or something like that). So I am trying to eat less bread, pasta, potatoes, etc. and more protein.

If your doctor is suggesting it, cut out some (unhealthy) carbs - like white breads, pasta, potatoes, etc. You should still have fruits/veggies and some whole grains. It's really not a huge deal. 

I've been overweight my whole life and have heard IT ALL from EVERYBODY, so nothign hurts me anymore.

I know it is hard, but just try to remember that your doctor has your and your LO's best interests at heart.  It is true that you want to watch the carbs ANYWAY in pregnancy -- protein and produce dont' tend to make us gain weight, but carbs / sugar do, and it can have an adverse affect on insulin, etc. 

Hang in there.  If you eat healthfuly already, please don't feel the need to justify it to anybody, just stay healthy and do the best you can!

 

beckajw:

Generally, a doctor who says "watch the carbs" doesn't know what he/she is talking about.  What should have been said is "watch the refined carbs."  Fruits and veggies are carbs and the doctors want you to eat those.  However, as far as weight gain is concerned, the carbs or lack thereof will not really have much of an effect.  It is how much you eat, not what you eat that causes weight gain.  Your calorie intake sounds good.  I wouldn't worry about the weight.  16 pounds at 24 weeks isn't a bad place to be.  I would, however, take the exercise advise.

Yeah.  1700 calories of fried processed crap = 1700 calories of lean protein and fruits and vegetables.  Insert eyeroll here. 

Meh.

My doctor is amazing, wonderful, and highly respected in our area.

I gained 50 pounds with #1, and 45 pounds with #2.  I was so nauseous and eating was the only thing that calmed my stomach.  With #2 I gained 22 pounds of it during the first trimester, and only 23 more the whole rest of the pregnancy.

My doctor never said a thing about my weight.  She asked me if I was taking some walks and trying to make healthy choices, I hung my head in shame about the walking part, and she said women's bodies respond differently to pregnancy and you gotta do what you gotta do to keep working and taking care of your family (ie eating to ward off nausea).

I started off around 120# and 5'3".  I passed all my glucose tests.  I had normal sized babies (7.5 pounds) after normal vaginal deliveries.  I lost all the weight +10 pounds after the last one. 

I felt really bad about things during the first two pregnancies.  Now I have tried to come to terms with how my body works during pregnancy.  As long as everything else is progressing normally in my pregnancy I try not to focus on it.

ETA:  I do not think any outrage should be applied to a doctor, however, that tries to encourage healthy weight gain.

It's very easy to comment about this from the outside, if I hadn't had the experience with DD the first time I would probably tell you to eat healthy, workout and brush off their comments- but I gained 65 lbs with DD. When I went in for my 24 week appointment I had gained 27 lbs and my OB told me that if I didn't gain another pound I would be fine (unrealistic for the remainder of the pregnancy, but she was trying to get her point across). At 32 weeks I had gained 45 lbs and she threatened to put me on bed rest because I was 'swollen' (or just carrying a lot of extra weight...) I sat in the car and balled my eyes out, called my DH and he couldn't understand a word I was saying. Truth be told, I over indulged A LOT and didn't get the exercise I needed. Doctors probably just make assumptions based on weight gain, and it shouldn't be that way.

I have always had issues with my weight and body image- this time I worked out six days a week and hadn't had a carb in months before I got pregnant with DS this time. I followed a strict diet/workout regimen to maintain what i had worked so hard to get to. My body had adjusted to that lifestyle and the second I start adding in the additional calories, necessary (complex) carbs (i.e. sweet potatoes, whole grains) dairy, and cut the heavy weight training and sprints I started gaining a little weight. I've put on 14 lbs total, 2lbs from weeks 8-12, 0lbs from 12-16, 10lbs from 16-20 and 2 lbs from 20-23. 

I'm sorry that they didn't offer more than just work out and watch your carbs, it can be hurtful. Let them know next time that you are extremely sensitive about your weight and that you are eating healthy and working out, maybe even complete a food diary for a week to bring to them in case they call you out again. I'd love to only gain 25lbs this time, but hell, I'll be happy with under 40 because I know how my body gains weight (I used to weigh 205 when I was younger, lost 70 lbs, got back up to 200 when I was pregnant with DD and lost it all again). If you've weighed more in the past your body has amazing memory and feels comfortable going back there, and it's harder to fight that as well. But you also know that you can always get back to that point as long as LO is healthy throughout the pregnancy, which is what your OB is there to monitor.

With all of the weight I gained, DD was born one day early- my OB was concerned she was going to be way too big with my weight gain so she induced and DD was born weighing 7lbs 10 oz and 22" long.