Overweight and Obese Pregnancy

As we have seen in the context of a reality TV star’s pregnancy, an obese mother who has undergone bariatric surgery might experience nutritional deficiencies that can affect the developing fetus, especially if she did not wait long enough to let her body become accustomed to its new situation.

But that is not all. Sadly, the risk can apply to any expectant mother. Whole industries have been built on prenatal nutrition. Iron and folic acid have been particularly emphasized, and more recently, Vitamin D has been brought to the foreground.

Government guidelines recommend fatty fish, orange juice, eggs, and fortified milk, because Vitamin D is seen as essential for the baby’s bones and teeth. Recently, another reason for concern became apparent, summarized in the title, “Pregnant women deficient in vitamin D may give birth to obese children.” Journalist Zen Vuong wrote,

Animal studies have shown that vitamin D suppresses pre-fat cells (adipocytes) from maturing into fat cells. Test tube studies of human fat cells also showed that vitamin D may hinder pre-fat cells from turning into fat cells.

Naturally, other researchers came along and wondered what this might imply for pregnant humans. A team from USC’s Keck School of Medicine suspected that Vitamin D deficiency might “preprogram babies to grow into obese children and adults.”

They looked at women who had registered very low levels of Vitamin D during their first trimesters of gestation, and then looked at their children at age six. These children had 2% more body fat and half-inch larger waistlines than the children of mothers who had been Vitamin D-sufficient during the same stage of pregnancy.

This may not sound like a big deal, but by now it has become very obvious that giving childhood obesity even the tiniest head start can result in a snowball effect. The earlier obesity gets a foothold, and the longer it persists, the more difficult it will be to ever escape. The study’s senior author, associate professor Vaia Lida Chatzi, told the press,

It’s possible that children of mothers with low vitamin D have higher body mass index and body fat because vitamin D appears to disrupt the formation of fat cells. Optimal vitamin D levels in pregnancy could protect against childhood obesity…

Despite increased suspicion, even more pregnant women are Vitamin D-deficient than ever, about two-thirds of them, in fact.

Obese moms result in obese kids

Here are a couple of intriguing notes on the causation of childhood obesity. A recent French study suggests that…

[…] the triggering of stress in a complex membrane system within all cells called the endoplasmic reticulum (ER). That stress leads to critical changes in the development of the hypothalamus, a part of the brain that controls hunger, satiety, and metabolic rate.

A recent report looks at the possibilities inherent in various anti-obesity interventions delivered during a child’s first two years, to counteract the risk incurred by parental weight and other conditions. Another article describes a projected five-year study, saying,

Although pregnancy complications, such as gestational diabetes and large-for-gestational-age birthweight have been associated with increased obesity risk in offspring, very few successful interventions in pregnancy have been identified… Data regarding maternal glycaemia in pregnancy, maternal nutrition, infant birthweight, offspring feeding behavior and milk composition will also be collected.

Meanwhile, it is important to spare a thought for overweight and obese mothers-to-be. Even the most uncomplicated pregnancy can include a plethora of side effects — fatigue, nausea, frequent urination, constipation, dizziness, broken sleep, heartburn, hemorrhoids, leg cramps, shortness of breath, swollen feet and legs, backache, congestion, gas, fluid retention, and more.

Now imagine dealing with all those miserable symptoms when every unit of discomfort is exaggerated by the presence of an extra 50, 100, or 200 maternal pounds. Mothers and babies need all the help they can get.

Your responses and feedback are welcome!

Source: “Pregnant women deficient in vitamin D may give birth to obese children,” USC.edu, 02/13/18
Source: “Cellular stress makes obese mothers have obese babies,” MedicalXpress.com, 03/16/20
Source: “Addressing obesity in the first 1000 days in high risk infants: Systematic review,” NIH.gov, 03/29/21
Source: “Antenatal Determinants of Childhood Obesity in High-Risk Offspring: Protocol for the DiGest Follow-Up Study,” MDPI.com, January 2021
Image by Frank de Kleine/CC BY 2.0

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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