Putting Fetuses on Diets?

Thanks to reader Holly for the suggestion for this blog.

You may have heard about the drug trial of giving obese pregnant women the drub Metaformin to see if it keeps babies from being obese. Or something.

According to Pharmaceutical National News:

Women who are overweight give growing babies too much food and, as a result, both can experiences subsequent health issues. Those involved in the metformin research trial will examine whether the drug can control these food transfer levels.

What with the who now? I’m definitely not an expert in this but that’s not how I remember infant nourishment working.  So I googled “How does a fetus get fed?”  The answer from http://www.laboroflove.com was:

While the baby is in the womb he receives his food and nutrients from his mother. The baby is connected to the placenta by the umbilical cord. This cord carries nutrients straight to the baby and nourishes him for the time he is in the womb.

That’s what I remember.  So when they say “Women who are overweight give growing babies too much food” does that mean that they assume that every overweight woman overeats?  If the problem is that mothers who overeat give their fetuses too much food then, even if the intervention works, it should be prescribed to women who overeat  – not women of a certain size.  If I’m following this correctly then once again the lazy medicine of substituting weight for health or behavior means that some large women will receive the medication even though they eat normally (ostensibly under-nourishing their fetus?) and some thin women who overeat will not be given the medication, thus exposing their babies to all of the “risk” that this treatment is supposed to solve.

But The Imperfect Parent elaborates:

Metformin reduces blood-sugar levels, which is passed on to the baby

Ok.  So this is for women who have high blood sugar levels? Problematically, not all obese women have high blood sugar levels.  Once again, if the treatment is indicated for pregnant women with high blood sugar levels, then shouldn’t we be testing their blood sugar instead of their height/weight ratio?

I’m also very concerned about how this will give additional momentum to the trend of putting babies on diets.  You read that right.  Babies. On. Diets.

Britainny and Sam Labberton were convicted of starving their baby out of fear she would become fat, because her father is fat. After the baby gained only 1 pound in her first two months of life and her bottle was found to contain traces of laxatives they faced criminal mistreatment charges. According to court documents after the infant was placed in foster care and gained weight, her mother’s reaction was, “Oh my God, she’s fat … I have a fat baby.”Hopefully somebody ELSE has a fat baby and this lady has a long jail term.

Parents are putting their kids on low-carb diets, low calorie diets, highly restricted diets, gluten free diets despite no sign of gluten intolerance.  They are putting water and skim milk in their baby’s bottles instead of formula. They are electing not to breastfeed because breastfeeding is known to cause weight gain in babies.

We keep hearing that in the last 20 years rates of childhood obesity doubled.  Well, between 1999 and 2006 the number of children under 12 years old hospitalized for eating disorders doubled.

Children under 12.  Under Twelve.  UNDER TWELVE.  With Eating Disorders.  If we’re going to do the “won’t somebody think of the children” thing then can we please think of these children too?

I’m also concerned that our obsession with childhood thinness (not health, thinness) is not only causing kids to have a lifetime of issues with their own body image and with food, but is also producing a generation of kids who erroneously conflate weight and health and are judgmental and inappropriate and going to end up getting a smack down in this blog someday.

I remember when kids would talk innocently about fat people:  “Mommy, that is the fattest lady I’ve ever seen”.  Just like a little kid to make a plain true statement.  Not a value judgment, just statement. The kid could have just as easily said “Mommy, that flower is blue”.

But now, with Michello Obama encouraging kids to wage war on their fat peers, it seems that the tides may have turned:

A commenter on another post here wrote:

When I was volunteering in my kindergartner’s classroom, and a little boy said, “Your belly is proof that you’ve eaten too many sweets.” The first time was when a kindergarten-age Girl Scout said, “Miss L? I think that when you were young, maybe you didn’t play sports or eat the right kinds of foods.”

The commenter asked me what I would say and my response was “Nope.  People just come in different sizes.  Just like in nature there are big dogs and little dogs, big cats and little cats, big tress and small trees, there are people who are bigger and people who are smaller.  I’m a big person”.

But what I want to say is “Where are you getting this from? Go find whoever told you it was ok to speak to someone like that and bring them to me so that we can have a little come to deity meeting.”

Let’s be honest:  Even if the statistic about childhood obesity is true (and there is a lot of controversy about that), nobody knows why.  A hundred years from now we could find out that it was due to something in the air and nothing could be done to stop it.  We could find ourselves in another ice age and discover that the fat people are the ones who survive.  Nobody knows.

So before we start starving babies, maybe we could take a step back and consider the idea that health is both mental and physical.  So not only does a Health at Every Size approach of focusing on healthy food and behaviors make a ton more sense than medicating a fetus, it also has the benefit of creating children with a healthy relationship to food, exercise and their bodes.  There is plenty of research that shows that starting to diet early and dieting repeatedly can cause irreparable harm and changes to the body.  I haven’t seen research on it but  I’m going to go out on a limb and say that I think dieting in the womb is just a bad call.

I’ve said it before, I’ll say it again (and again, and again):

Weight and Health are two different things and cannot be freely substituted for one another.  Health is multi-dimensional and includes things in our control and things out of our control such as genetics, environment, access, stress and behaviors, and being healthy is not the same as being thin. There are healthy and unhealthy people of every shape and size.  Therefore, if you want to be healthy doesn’t it make much more sense to focus on healthy behaviors instead of making our bodies smaller? I say yes, including and especially for children, babies, and fetuses.

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Published in: on June 6, 2011 at 8:25 am  Comments (48)  

48 CommentsLeave a comment

  1. Im not sure that I like this topic you have chosen to write about today. While you seem to have a very strong opinion on the topic you admit that you had ‘trouble finding clear information about how and why this is supposed to work’, but still felt that you could answer with full knowledge. I think that maybe you should research the problems that can occur to mothers and their babies when a baby is over weight. There would have to be vast research and documentation as to why this drug is now offered to obese people…..and why!
    When I was pregnant with my two children I was not over weight or obese but was put on metformin for gestational diabetes. The risk for me was that any food I ate that was turned into sugar was soaked up by my baby resulting in an overly large belly. This large belly would cause me problems if I delivered naturally. It could also cause trauma to my baby’s shoulders. There is also the risk that the large amount of sugars that my body as taking in and transferring to my baby would result in a dramatic drop in sugar levels once born. There are many complication that can arise from larger babies.
    I agree with you that not all obese women are over eaters but what happens to their food inside their bodies to become the size that they are can also happen inside the baby’s body. A pregnant mother could eat brown rice and grain bread, fruits and vegetables but the way the body breaks down that food and turns it into sugars can result in more weight on them. This food although healthy can do the same when passed to the baby. So I dont think the study is suggesting that all obese people are over eaters or eating the wrong foods but is mearly helping those whose bodies may not break down food properly (and I use the term ‘properly’ very losely), so they can help their babies.
    Why would you not take the option?
    You may not because you havent research it as well as you should have.

    • Hi Lisa,

      Thanks for taking the time to comment. I take exception to your assertion that I felt I could “answer with full knowledge”. I think that this is an important issue to talk about not just for the primary issues but also for the ancillary ones that I talked about. I stated up front that I had trouble finding information about it so that it was clear that I am not speaking with full knowlege It think I actually said in the blog specifically that I’m not an authority. I asked a lot of questions in the blog. I also wanted to point out the lack of clear information on the subject.

      My point, and I stand by it, is that there is no evidence that all obese women experience pregnancy the same way and so if the pill is being used for women who have gestational diabetes then we should test for that, if it’s being used for women who overeat then we should test for that, and if it’s being used for women with high blood glucose that is not diabetes level then we should test for that instead of being lazy and just giving the medicine to every pregnant fat woman. You mentioned that “A pregnant mother could eat brown rice and grain bread, fruits and vegetables but the way the body breaks down that food and turns it into sugars can result in more weight on them. ” You are exactly right about that, however that pregnant mother could just as easily be thin as fat. Unfortunately under the current test an at-risk thin woman would not be given the drug but a healthy fat woman with no blood glucose issues would be given the drug. I think that’s a huge problem

      I’m having trouble with what you said about “helping those whose bodies may not break down food properly and I use the term ‘properly’ very loosely so they can help their babies.” Your point is extremely vague – “may not break down the food” is not a diagnosis. Does the body break down the food or not? Simple blood tests can give us information on that. Using the term “properly” loosely seems like a bad idea if the outcome involves giving medicine to a fetus.

      As far as why I wouldn’t take the option: I wouldn’t take it if the only diagnosis was my weight, because body size is not a diagnosis. In my case my blood sugar is fine and so if I did take the option it appears taht I would run the risk of under nourishing the fetus. I wouldn’t take the option without a ton more research because I remember the thalidomide disaster and wouldn’t want to be part of the next incarnation of babies who are damaged for life because we jumped the gun on an in utero treatment.

      I can certainly understand why you would take exception to the blog and I really do appreciate you taking the time to represent a different point of view. Thanks!

      ~Ragen

    • Women have been delivering since the dawn of time with large bellies and this has not given them problems delivering or damaged their baby’s shoulders.
      I’m sorry, but you have been misinformed

  2. I find it extremely worrying that what is implied here is that this study merely concerns itself with lowering babies’ birth weight. I was an extremely skinny baby, because I was born three weeks too late. My parents even lied about my weight on the card they sent out to friends and relatives, because they didn’t want them to worry. A low birth weight is not necessarily a good thing. I was nearly dead. During my entire childhood I was a very skinny kid and I have only now made up for that. Now I am a happy fat person without anemia, yay! My low birth weight did not make me permanently skinny.

    An aunt of mine was born right after the second world war. Her mother was malnourished during pregnancy and barely had enough milk after my aunt was born. My aunt now has diabetes, a condition which is linked to malnourishment during pregnancy and early childhood years. It certainly isn’t in our family, as she is the only one who has it.

  3. The drug is in the experimental stages of testing as a treatment for women who develop temporary diabetes while pregnant. It’s already a standard treatment for type two diabetes in adults under the brand name Glucophage. Whatever the rights and wrongs of all that, I don’t see what that has to do with fat women who are pregnant. If there is a better treatment than insulin for gestational diabetes, then great. But giving all pregnant women who are fat unproved medication in hopes of keeping their fetuses skinny sounds like abuse to me, pure and simple.

  4. It’s my understanding that medical testing isn’t done on pregnant women because it’s considered a violation of medical ethics. This is because the woman can give consent but the fetus can’t. So researchers can collect data on the pregnancy but they can’t manipulate outcome with traditional methods such as placebo and double-blind studies. I’m sure it’s more involved and complicated than that, but that’s my base understanding. But with that in mind, they’re probably collecting and studying data on birth weights of babies born to women taking Metformin during pregnancy rather than prescribing it to see if it eliminates fat babies.

    • Actually pregnant women have lots of medical testing. Blood tests. Ultrasounds. Amnioentesis.
      And it’s not considered a violation of medical ethics.Just like parents can approve medical test on their children after they are born.
      I’d agree that prescribing medication to keep babies from being fat seems pathological as opposed to a good idea

      • What she meant by the term “medical testing” was controlled studies, like the drug test described in the post. The kind of medical testing that you’re thinking of are tests that are performed in order to obtain information about the pregnancy, which are totally different.

  5. I am a big girl. Always have been. I have had two healthy pregnancies, neither of which resulted in diabetes of any sort. My blood sugar was fine the entire pregnancy. My kids were both born in normal range – one was 22.5″ and 9 lbs, the other was 20.5″ and 7lbs 15oz.

    When I was pregnant with my son, my first, the doctor said not word one about me being overweight (I am 5’9″ and was about 270lbs at the time). She treated me like every other patient. For my second child, I was in another state and had to find a different doctor. I weighed almost exactly the same thing. When I went in for the first visit with her and was only about 5 weeks along, she sat me in her office, closed the door, and said, “You understand that this is VERY serious. You are not to gain ONE OUNCE with this pregnancy. Now, I can’t encourage you to diet, but you need to be very mindful of what you eat.” Then, shocked because I am a very healthy eater in general and did not have any other problems like high bp or diabetes. I got up to leave and asked her for a Rx for prenatal vitamins – she got up, went to her cabinet, and pulled out a few sample packs from pharm. reps. Then she said, “Call me when you bleed.”

    I was FLOORED. I sat in my car and cried my eyes out thinking that this medical professional thinks I am so unworthy of carrying a child that she implied that I would miscarry! It was awful. I never went back to her, and instead found a fantastic doctor who accepted me for who I am. Healthy pregnancy was had and my beautiful baby girl just turned 4 this weekend.

    I fear that doctors like that one are the kind that would take this as gospel. I would hope that if this becomes a standard in prenatal care, enough women do research and refuse treatment is their gestational diabetes screen comes back negative.

    • … Where’d this lady get her medical degree? You can not HELP but gain weight. Despite my being on a strict diet due to diabetes, I still gained 20lbs with my second son. THAT is to be expected! What was this lady’s problem?! If you’re overweight, Doctors would /rather/ you not go over the expected weight gain, but man. I recall with my first son, for some reason, I just dropped like 30lbs. And my doctor was in a panic. I never been told so much in my life of “You can’t diet. YOU CAN NOT DIET.” It was a moot point because I assured him I was listening to my appetite and my body and wasn’t ignoring it. It was just some weird fluke. And even with the baby I had diabetes with, /I/ had panicked when I was pressing 20lbs gained at about 7mos. But I guess I was fortunate. OB assured me to just relax and that if I go “over” a few lbs, no one’s going to say anything. I’m so glad you found a new doctor!

      • I completely agree! I’ve only gained 25lbs with both pregnancies – she was just nuts! I have another friend who went to that practice recently and the female doctor who I spoke with that day is no longer there. I can’t find her listed anywhere in town, either. Good riddance as far as I’m concerned.

    • Oh.My.God. I don’t think I would have been able to make it to my car to cry. I probably would have unleashed a HELL of fury on that ‘doctor’. I can’t handle it. I want to right now! Lemme at her!!! Seriously…how anyone like that can stay in practice is just beyond me. I once was completely taken aback because a doctor told me that I most likely would not be able to conceive at my weight (5’3″, at the time I was nearing 200 lbs), and that if I did, having a child would be near impossible. I have since learned that this isn’t true, but still, it has been with me for about 10 years, lurking in my mind for when I choose to try and conceive. GOOD for you for finding a doctor who treated you as a human being, and not a number, hopefully that doctor is no longer practicing.

  6. I…wait what?

    Metformin is a drug to treat Diabetes. It’s an alternative to Insulin. It helps the pancreas with it’s sugar-regulating duties. It also is used to treat PCOS (Polycystic Ovarian Syndrome) as PCOS has been discovered to have a link to Insulin-resistance, and thus, Diabetes. Metformin tends to be used in Diabetes cases where the case is more insulin resistance (It takes more insulin to produce ‘normal’ results than what’s normal) vs ‘not producing enough insulin’. It just helps the body use the insulin it produces (which is theoretically enough, it’s just not working).

    Metformin, like any glucose-lowering drug, does not Automatically Aid weight loss. It aides in weight loss due to helping the body regulate it’s sugar levels, and… IT IS NOT A GUARANTEE. Why do I know this? I’m on Metformin. I’m treated for PCOS, though as a pre-Diabetic (as I mentioned before, I developed Gestational Diabetes), it does help in that regard.

    The only way it will keep babies from ‘being obese’ In utero, or whatever, is if the mother was Diabetic herself. Why? The major risk factor for Gestational Diabetes is it casues the baby to be too large, and disproportionately so, in the torso. This can lead to premature delivery and the organs not being as developed as they need to be. Again, there’s that qualifier: Diabetes. And if you’re a gestational Diabetic, you’re already on a strict low-carb/sugar diet to begin with.

    This should not be used just willy nilly to ‘control weight in utero’. You want to control in utero weight? Make sure the MOTHER is being mindful and not eating 5 sundaes in one sitting just because she thinks she can get away with it due to being pregnant. Also, the body is a wonderful thing, esp. during pregnancy. The Placenta will, more often than not, regulate what goes into the baby. It’s why even if a mother gaines more than the recommended amount of weight during prengancy (~25lbs), the baby will likely still be considered an average birthweight (~7.5lbs).

    Ugh, sorry for the rant. It just, I’m on that drug. IT SHOULD NOT BE USED THAT WAY D:

    • I so agree with you. Why are we throwing experimental treatments at women instead of advocating for healthy eating/habits during pregnancy? I cannot think of a better time in a woman’s life to eat healthy and mindfully than during pregnancy. Instead, doctors are assuming fat = overeating and throwing a pill at women. Why not, instead, sit down with ALL pregnant women, no matter the size, and have a discussion about healthy habits during pregnancy, to include eating and exercise.

    • I agree with you 100 percent! Not only that, but type 2 diabetes can be gotten by having chronic low blood sugar (ie. not eating for too long, too many times) and then once you’ve got it, you always have too much sugar in your blood. THAT is when you want metformin. If you take drugs that lower blood sugar when you don’t have diabetes, you could actually *cause* yourself to get diabetes.

    • I want to add that if you have PCOS, you might want to look into OTC bioidentical progesterone cream. PCOS can be caused by imbalances in estrogen/progesterone levels. The metformin may address one of the symptoms of PCOS, but it’s a band aid. The progesterone could actually resolve the condition, which would resolve the blood sugar issues without metformin.

      A lot of doctors are very fond of treating with band aids instead of correcting the underlying hormonal imbalances. This is especially true with diseases like PCOS and hypothyroidism.

  7. Babies are supposed to gain weight, they are growing. Geez.
    I’m more concerned about children that don’t know how to go outside and PLAY versus sitting in front of a TV watching violence and playing games.

  8. I hate to think that parents are putting babies on diets. That sickens me.

    I went on my first diet at around age 11. If I could go back in time and tell myself, “Leah, you’re going to grow a foot taller next year and all of this weight that you’ve gained recently is HEALTHY and perfect for your upcoming growth spurt, so don’t start restricting your food; just be a kid!”, I would. That was the first of many diets, and the true beginning of my disordered eating.

    For me, when I was fat, I was unhealthy. I only know this because when I started to focus on eating and exercising in a healthy way to get my health where I wanted it, I lost a bunch of weight, too.

    I know this is not the case for everyone, and I thank you for bringing that to the limelight. 🙂

    • I’m so glad we never did that with our son; he did the same thing; had that growth spurt – probably did grow a foot taller – couldn’t believe it and just slimmed him right up but then he did start getting more active as well – plays volleyball almost every night

  9. This was a great post. Drugs should only be used when appropriate. As PPs have noted Metformin is used to treat PCOS/diabetes, and should absolutely NOT be given to all fat pregnant women. There was a push a while ago (still?)to give fat women cholesterol lowering drugs during pregnancy, because everyone’s cholesterol rises in pregnancy. As for this;

    “This large belly would cause me problems if I delivered naturally. It could also cause trauma to my baby’s shoulders.”

    I’m sorry, but whoever told you that was misinformed. Gestational diabetes can have serious consequences for mom and baby, but unless your baby is huge (I don’t mean 8-9 lbs, I mean very large), you shouldn’t have any issues delivering it with the proper labor support.

    • Yes, exactly. My second son was to be an estimated 10lbs (and that was /not/ taking into account any size issues with the diabetes), and my CompOB was still trying to get me to agree to a vaginal delivery. So yeah, if they were willing to attempt to deliver a 10lb baby (He was unfortunately born premature 5 weeks prior due to me developing preeclampsia; he STILL weighed nearly 7 and a half pounds!), there shouldn’t be eyelashes blinked at closer to the average size babies.

      • would you say the diabetes had anything to do with the preeclampsia; my other – also diabetic – daughter-in-law – had that happen with her daughter

  10. Despite being fat, I did not get gestational diabetes, I actually got the opposite, a tendency towards ketoacidosis. Metformin would have made this much worse, since it inhibits gluconeogenesis, which is the bodies natural way to prevent of preventing blood sugar levels from dropping too low.

    In both pregnancies I weighed less immediately before I went into labour than I had at my first anti-natal appointment. I ate normally during the pregnancy. For the record, the odd occasion I have been on the contraceptive pill I have also lost weight.

    When I was in anti-natal classes, the midwives reassured us that regardless of what we ate, how much or how little we ate the baby would be fine because the blood went to the placenta first before it supplied our own needs – this came about because some women were concerned about being sick throughout the pregnancy.

  11. I wrote about this here http://motherhoot.com/blog1/?p=2115.

    This is going way to far. What do we do?!

    xo Susie

  12. Babies’ brains are rapidly developing, and a huge part of that developmen involves myelination. Myelination requires fat and cholesterol in much higher proportions than adults or older children need. Babies, like all humans, come in every shape and size, but their caloric intake should never be restricted. Babies are supposed to be proportionately fatter than (what medicine considers to be healthy) adults!

    Preaching to the choir, I know, but I had to get that off my chest.😉

    As to the metformin, the story makes me even more grateful than I was (if that’s even possible) for the wonderful midwifery care I enjoyed during all three of my pregnancies. When we discussed food, my midwives were concerned to make sure I was getting plenty of protein, just like they would be if I had been a much smaller mom. I had 3 perfect, healthy babies because in spite of being fat and in spite of not taking blood-sugar reducing drugs, I did not have gestational diabetes!

    And drugs for a condition that doesn’t exist? All drugs carry risks. I prefer to take on those risks only when necessary, thankyouverymdrugs!

  13. I had not even heard of the parents who starved their child and I know you indirectly point it out, but it needs to be emphasized how fatphobic of a culture we live in that a parent would find it necessary to starve their baby when it is generally held knowledge, or at least I thought so, that babies needs lot of nourishment so they will grow properly. To focus on the parents’ individual pathology for doing this is significant, but I just have to overly emphasize how screwed up our society is that it is making people worry about fatness in babies.

    A friend of mine did a performance piece, which argued that fat people are becoming the new poor people where society uses them as the scapegoat for pretty much everything. I also got her into your blog and she loves it! =)

  14. Ragen-

    Normally I’m in full agreement with you. We share many of the same beliefs in terms of body perception issues, health, and the idea that overweight automatically means unhealthy. However, I think you should have spent a little more time in research. It took quite awhile before I found the original study. I am also a bit worried about what the study implies. I do think, though, that you were a bit quick to jump to the following argument:

    “If I’m following this correctly then once again the lazy medicine of substituting weight for health or behavior means that some large women will receive the medication even though they eat normally (ostensibly under-nourishing their fetus?) and some thin women who overeat will not be given the medication, thus exposing their babies to all of the “risk” that this treatment is supposed to solve.”

    The majority of women who receive prenatal care are tested for gestational diabetes, regardless of size. Obesity and insulin resistance are both comorbidities of GD. Remember, that doesn’t mean that one or both will automatically cause GD, just that they are known to be contributing factors. Previous studies have also shown that children who were born from mothers who had GD are more likely to be obese.

    The purpose of the study, then, is to determine if the use of metformin will reduce the incidents of GD in women who have comorbidity factors for GD and who have not already had it. Why is this important? On a more immediate level, GD leads to large birth weight infants which increases the need for Cesarians and causes other complication during pregnancy that can affect both the health of the mother and the fetus.

    There are currently at least four other active trials in multiple countries that are tracking the use of metformin during pregnancy to directly control GD. This is simply the first trial to use metformin in women who have not developed GD. A secondary consideration is the long-term impact of reduced GD and a reduced incidence of obesity in children born from that type of pregnancy, as it were. There is at least one other study that is already tracking the health of children whose mother’s had used metformin during pregnancy to control GD.

    So why use metformin only in pregnant women who are obese? The idea of the trial is to see whether there is a more positive outcome to already potentially difficult pregnancies. I am NOT saying that skinny = easy pregnancy, far from it. I am merely pointing out that there is already an increased risk for GD and its complications in the population that is clinically obese. At the same time, I don’t think that a pill should be given to every “fat, pregnant” woman. I think we all agree that women need to be given quality, informed, sane(!) prenatal care.

    As for the remainder of our blog post, I do think we are a little hyper at times. There will also always be individuals who take their fears to the extreme. For example, even as I generally detest baby pageants, do I believe that Botox mom is generally representative of all of those parents? No, I see her simply as an extreme (and media hungry) example.

    • Hi Richard,

      Thanks for the comment. The object of this blog was to ask questions not answer them. Hence all of the qualifying terms, questions and the use of phrases “if I’m understanding it correctly”. I do take exception to you saying that “this is simply the first trial to use metformin in women who have not developed GD”. It’s not women, it’s only obese women. We seem to agree though as you say “At the same time, I don’t think that a pill should be given to every “fat, pregnant” woman. I think we all agree that women need to be given quality, informed, sane(!) prenatal care.” which was exactly my point.

      You said “The idea of the trial is to see whether there is a more positive outcome to already potentially difficult pregnancies.” I’ll have to see the studies statement of purpose, but I do question the language “potentially difficult”. Not all obese women have difficult pregnancies and if we give obese women this drug prophylactically how will the doctors know if they would have been difficult? Again, it seems like there must be better subject parameters than just a ratio of height and weight.

      As to your last paragraph, referring to this as “our blog” and saying that “we are a little hyper” read to me as unnecessarily condescending. That being said, I don’t believe that I said that all parents are putting their babies on diets but there has been an acknowledged trend in this area and I pointed out the fanatical end of the spectrum and my concern that this drug trial and its subsequent publicity will add to this trend.

      You know that I respect you tremendously and I absolutely appreciate your comment.

      ~Raegn

    • “As for the remainder of our blog post, I do think we are a little hyper at times. There will also always be individuals who take their fears to the extreme.”

      But the point is, whether or not there will ‘always’ be people taking things to the extreme, people should *always* speak out against these extremes. To not do so gives a silent compliance with these extremes.

      Also, seeing as there are other other risk factors besides weight in developing gestational diabetes, we should probably have women with those risk factors tested as well, right? (Oh wait, it’s just the fatties)

      btw, this is what the mayo clinic says are the risk factors for developing gestational diabetes:

      Age greater than 25. Women older than age 25 are more likely to develop gestational diabetes.
      Family or personal health history. Your risk of developing gestational diabetes increases if you have prediabetes — slightly elevated blood sugar that may be a precursor to type 2 diabetes — or if a close family member, such as a parent or sibling, has type 2 diabetes. You’re also more likely to develop gestational diabetes if you had it during a previous pregnancy, if you delivered a baby who weighed more than 9 pounds (4.1 kilograms), or if you had an unexplained stillbirth.
      Excess weight. You’re more likely to develop gestational diabetes if you’re significantly overweight with a body mass index (BMI) of 30 or higher.
      Nonwhite race. For reasons that aren’t clear, women who are black, Hispanic, American Indian or Asian are more likely to develop gestational diabetes.

      (Sidenote, I’m sad that the mayo clinic/science turns to racism rather than look at the socioeconomic factors which effect diseases of “Nonwhite races” )

      • my now daughter-in-law did indeed have a stillbirth that they said was caused by her gestational diabetes, which had not been diagnosed yet at the time – don’t they typically not test for it until 28 wks.?

  15. My head nearly imploded when I first read this article a couple weeks ago. Society has officially lost its mind.

    I wish every would-be and current parent knew about Ellyn Satter. She is a HAES-oriented expert in infant and child feeding and her books are brilliant (she also has a website full of free information). She has researched the correlation between abnormal weight gain in babies and children and food restriction by well-meaning parents. Babies are all born with the innate knowledge of how much to eat, and food restriction only serves to mess with those internal cues, often for life unless there is an intervention. It often produces lifelong over-eaters (and on occasion, under-eaters).

    If there is an increase in childhood obesity, I can only think that one cause would be the food restriction that health care professionals are often guilty of recommending to parents with (normal) fat babies. I shudder at what starving the fetus will produce.

    Thanks for this post – this trial is an egregious use of science.

  16. As a woman who takes a high dose of metformin daily (and did to not only get pregnant but also during my pregnancy) this pisses me off. Not your Blog post, but the babies on diets thing. I am pcos and insulin resistant. While the medication is traditionally given to type 2 diabetes patients to help their bodies process insulin, it is also used to help women with my condition ovulate and stay pregnant, as there is a higher incidence of miscarriage for women like me. So yes, I took metformin and I still do, and I have a healthy and happy little girl because of it.
    The problem comes when the original purpose (treating insulin resistance, etc) gets lost under the day’s headlines. The jackasses responsible for this one need to have their heads examined. I am prescribed and take my medication because of verified medical conditions and this medications proven ability to assist my body to function as it should. And that is the ONLY reason any doctor should be prescribing metformin to his or her patients. Period.

  17. Every article I see about this study says the drug is being given to obese, non-diabetic pregnant women in an attempt to see if it will keep the baby from being obese. Nothing else.

    I’ve said elsewhere: I am obese, but my pregnancies are free of complications and though my babies are born large (9lbs) they become slim children. My 10-year-old is watching a movie with a bag of carrots right now. Will she be obese when she grows up? I don’t know and I don’t care. I only hope that she will be healthy and above all, happy.

    Also, it is formula that shows an increased “risk of obesity”, not breastfeeding. Breastfed babies tend to be slimmer, though many are not. Feeding a baby at all will make them gain weight, though.

    I am completely against weightloss diets for people who are still growing. Children need to gain weight, not lose it. Their bodies go through so many changes, and wise parents encourage healthy habits rather than focus on how a child looks.

    It’s hard enough to teach my daughters that weight doesn’t matter without someone calling fetuses obese.

  18. Let’s see if this will work (seems lately, when I try to leave a comment, it doesn’t ever show up). Our kids are now 27 and 29. When my wife was pregnant with our son (the younger child), she had a long battle with morning sickness. The doctor chewed her out for LOSING weight during that time period, but it’s rather difficult to gain weight when you can’t keep food down. As a result, her body began to draw on her fat reserves to preserve the blood sugar level for both her and the fetus. The human body has been genetically suited to produce healthy babies for untold thousands of years, and these medical geniuses think they can improve on that with a stupid pill? I’m waiting to hear about the long-term side-effects that they didn’t count on from this idiotic idea. If we really want to focus on having healthier children, turn off the video games and get them outside and active on a regular basis. I’ll bet they’ll find far more positive benefits from that, then they ever will from prescribing another dubious pill.

  19. Clearly this is a complicated issue. I know next to nothing about pregnancy, especially in obese mothers, but I am glad you wrote about this topic. Perhaps even the fact that the information was so difficult to find and understand points to something as well. When it comes to obesity a lot of people, doctors, whoever, will jump to conclusions because of the mentality that “something must be done about fat people right now!” So this is certainly a situation where the mother’s and baby’s health might be put at risk needlessly. Though I think there are plenty of similar situations not influenced by this bias where some type of medical intervention is necessary. But again, I’m no doctor.

    Confusing as this topic is, it raises so many other issues that we MUST be talking about. The rising emphasis on child-thinness, which I see DAILY working at a grocery store, is going to come to some sort of sad pinnacle.

  20. What really gets me about the metformin use, is there is already a pool of mothers/children available for reasearch. Pregnant women who have diabetes and pregnant women who develop diabetes often need to take metformin. There is no need to put non-diabetic pregnant women on this drug “to see what happens” – the pool of data already exists – how about studying that group before you start giving a drug to people who don’t need it.

    • But they’re fat, so it’s OK to mess around with them. They’ll all die of fatness anyway, right?

    • I agree. I just can’t get past the idea that if the doctors are wrong about this then they are depriving fetuses of nutrition that they need. Yikes!

      ~Ragen

  21. I also wrote about this, but with more rage and less eloquence haha.

    My concern is the assumption that all obese women have difficult pregnancies. I’m “morbidly obese” (thanks BMI) at 5ft6 and around about (146kg) 320lbs (give or take). I was this weight through BOTH of my pregnancies. During my first pregnancy, with my son, my weight didn’t fluctuate at all; which means I was losing while He was gaining. My second pregnancy I put on about 11lbs (5kg). Neither times did I have gestational diabetes (and I don’t have diabetes of any kind normally). I naturally have high blood pressure – which doesn’t appear to be totally weight related (During times I’ve lost weight, my blood pressure has still been high) – and this INCREASED during my pregnancy but that didn’t make it a difficult one. Both babies were born naturally, and healthy. My son was 6lb13, and my daughter (induced at 37weeks) was 6lb7. I am utterly depressed at the notion that MOTHERS would consider taking this drug to protect their babies from being fat… wth constitutes as a fat BABY anyway????

    • There is a huge piece that I didn’t write about involving the fact that the “healthy weight” bmi chart for kids is a very recent development and is rather arbitrary. I absolutely agree with you that plenty of fat women have very healthy pregnancies. Thanks for the comment, congrats on your very healthy babies (however old they are now)!

      ~Ragen

  22. I actually blogged about this a few weeks ago, if you’d like to read my take. (Please feel free to correct my science, if you’d like to read!)

    I enjoyed your perspective as well though – you took it in a completely different direction than I did. And the quote from one of your commenters about questions from children… I retched. I just… I have no words. And I still have to try to convince people of the existence of the overwhelming stigma and hatred our culture has for fat people. The more I learn about the faux science behind the anti-fat hysteria, the more horrified I am at the whole deal.

    • I thought that your blog was great. There is certainly enough horribleness that there are plenty of directions that this can be taken in. Thanks for the comment!

      ~Ragen

  23. I am a fat mommy. I had both my children while I was over 300 pounds. I, like a previous poster, did NOT get GD, despite the OB’s near panicked death-knell of “OMG, pregnant fattie, she’ll have GD, just wait.” I actually had two perfectly healthy pregnancies, perfect blood pressure, blood sugar, perfect babies. Only complication was a genetic blood clotting disorder, requiring me to have c-sections. In fact, that blood clotting disorder led to TWO previous miscarriages that my ob told me had happened because I was too fat to even BE pregnant, and if she had done her JOB and tested my blood, rather than just “assume” I m/c because I’m a fat mommy. But back on point, this is just silly. We already test and treat GD when it happens. I know plenty of perfectly healthy “granola” mommies who work out, do yoga, have perfect weight/height proportions and end up with GD and then there was me, 4 pregnancies and not a wisp of any complications. I get that this is anecdotal, but really this is just more proof of how fat-phobic the world is. I wish some of these docs would actually get a dictionary and look up “causal vs. correlative” relationships. Shaking my head….

  24. Jeez Louise, putting a fetus on a diet?! I feel so sorry for both the women and the babies who are probably going to have birth defects. How dare the medical establishment experiment on people like that? It’s unconscionable.

  25. I’m in shock that there is actually a medical study trying to prevent unborn babies from getting all available nutrition. A fetus is going through a building process. It makes no more sense to restrict the amount of sugar available to the fetus than it does to tell the house construction team “You can have all the wood, brick and wires you want, but we’re only allowing 20′ of pipe”.

    Restrictive diets make no sense for those who are still developing. Anyone who has watched kids grow up who have the ability to run as much as they want (ie. play outside) has seen them go through cycles of weight gain and height gain closely following each other. Without the available nutritional resources, the body tends to not trigger the height gain. Take a look at clothing and furniture from times of relatively high malnutrition like the Middle Ages. People were SHORT.

    My mom was always on the underweight side of the scale (108 lbs at 5’6″) despite trying to gain weight repeatedly. When she was pregnant with me (first child) the doctor gave her a minimum amount of weight she had to gain or she would have an unhealthy baby! *Authoritarian Doctor Glare* She barely managed it by over stuffing herself. I came out at 9 lbs and her metabolism changed drastically. Now it seems “medicine” is working on the opposite side of the pendulum swing.

    BTW, Regan, I was first directed to your blog for the swim suit repost. I’ve been stopping by whenever I have the chance since then.🙂

  26. Even if the statistic about childhood obesity is true (and there is a lot of controversy about that), nobody knows why.

    My pet theory is that it’s caused by dieting.

    I would also seriously love to see data on the population-wide prevalence of dieting correlated with adult height. I still suspect that I got cheated out of at least one inch that I should have grown in my teens…

  27. All I can think of is “Does nobody remember thalidomide?”

  28. I know this is an old post but I’m just here to say… I wish I could eat more and therefore cause my unborn baby to gain weight! If only that’s how it worked…🙂 My baby is quite little for her age, and I’m overweight and I feel like I eat constantly (7.5 months pregnant). And yeah, overweight moms do often have healthy pregnancies. My doctor is kinda surprised at how well I’m doing… a good surprise, I guess. 🙂

    But the reality is that the baby takes whatever she needs from the mom… that’s why getting enough calcium is so important when you’re pregnant, because otherwise you could end up with bone or teeth problems. Babies leech whatever they need from Mom. 🙂 So with that in mind, isn’t putting the baby on a diet just hurting the mom?

    It’s likely that my baby is just little, and that’s fine by me as long as she’s developing well!


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