By Darline Turner-Lee
As new moms we love our babies. However, we are often less in love with our post pregnancy bodies. That once round, firm belly is replaced with a much softer, smaller mound that adamantly resists folding quietly into our favorite jeans. Most new moms I speak with are eager to return to their pre-pregnancy weights, yet I always advise my perinatal fitness clients that it took 9 months to put the weight on, allow 9 months to take it off. While it may come off sooner, a new mom has to give her body time to adjust.
For many of us, it’s surprising to discover that even our skeletons are completely different after giving birth (I went from a 5 ½ shoe to a 6 ½ -7 and from a size 34 bra to a 36 after having my children!). Our breasts are bigger and for most, far less “perky” then before breastfeeding as are many other areas of our bodies. Still, with a diet of wholesome foods and regular exercise, most women are able to lose their pregnancy weight and return to some semblance of “normal.
However, for some women, weight loss becomes an all out battle. They cut calories. They eat more fruits and vegetables than they can normally stand. They are exercising daily and still their weight won’t budge below a certain point. For these ladies I say, don’t despair. Your body may have other underlying imbalances that are conspiring against you. If you have truly been diligent about your weight loss efforts for 3-6 months and are unsuccessful, it’s time to explore some of the other, less commonly acknowledged factors that can affect weight loss.
Weight loss is often touted as a simple process in which calories taken in must be less than calories expended for weight loss to occur. However, weight loss is actually a very complex process. There are several physical factors, besides eating and exercising, involved in weight loss such that when they are not working properly weight loss is virtually impossible. Here are five other physical factors that can be sabotaging your weight loss efforts.
Stress: While she may not consciously perceive it, a woman who is worried about her baby, her family, finances or any number of life’s many stresses will experience a prolonged “Flight or Fight” response in her body. The constant worry has her adrenal glands working overtime producing cortisol to protect her body in the event of battle. The body cannot tell the difference between being stalked by a wild animal and worry over her finances, the physical response is the same. If this stress response persists, a woman is at risk of developing chronic diseases such as heart disease and diabetes. Robert Sapolsky, Ph.D, a Stanford neuroscientist who has studied the stress response extensively, describes this reaction extensively in his book Why Zebras Don’t Get Ulcers. The stress hormone cortisol increases our appetite while also increasing fat deposition around our midsections. If a woman wants to increase her weight loss success she must manage her stress. If she is not able to make adjustments on her own, she may need to ask for help with her daily obligations so that she can focus on her health and care or her newborn. If she is still having trouble, she may want to consider counseling.
Sleep: What new mother isn’t sleep-deprived? The constant feedings and nurturing that is necessary in the early days post partum are far from conducive to a good night’s sleep. Some mothers report that they don’t sleep more than 3 or 4 hours at a time for up to 2 years! While many people boast that they only need a few hours of sleep per night, the average adult actually needs about seven hours of sleep to function properly (cognitively and physiologically). When we sleep, our bodies remove wastes, repair cells and replenish our chemical levels. Our bodies also produce Leptin, a hormone that tells the body when it has had enough to eat. When we don’t get enough sleep, our bodies don’t have adequate time to get rid of waste products, repair damaged tissues or restore depleted supplies of hormones (Leptin) and other bodily chemicals. In an effort to conserve resources, our bodies hold onto whatever they have including excess adipose (fat tissues) and low Leptin levels signal us to eat more. If weight loss efforts are stalled and you know that you are not getting about 7 hours of sleep each night, you may want to try to incorporate a nap or make other adjustments so that you can get more sleep.
Hormonal Imbalances: Suffice it to say that a post partum mom’s hormones are all over the board. Between the hormones of pregnancy and the ensuing lactation hormones, women can be effectively imbalanced for up to 3 years depending on how long they nurse. If you are having trouble losing weight, you may want to discuss with your obstetrician or midwife your struggles and have some hormone tests run as supplementation or adjustment may be necessary.
Here’s a note to my fellow older moms. I had my son at 40 and nursed him for just under a year until my 41st birthday. When all was said and done, I still did not feel like myself. I asked my obstetrician what could be the problem and blood work she had analyzed said that my hormones were “within normal limits”. But I continued to struggle and finally consulted with an alternative practitioner. Turns out that while my hormone levels were “within normal limits”; they were all at the very lowest end of the normal ranges. By the time I was 42, I was exhibiting obvious signs and symptoms of perimenopause. I have since started taking bio-identical hormone replacement and am much better.
Many women note an increase in weight and abdominal girth as they go through the menopause transition. Although not the best source, fat does produce a bit of estrogen. As estrogen levels drop, the body tries to compensate by increasing adipose (fat) tissue. A doctor once told me,
“A woman’s hormones can begin to fluctuate as early as 30. We can’t know who will have premature ovarian dysfunction, i.e. early menopause and who won’t. Every woman is different and must be evaluated and treated individually.” If you are having signs of hormonal imbalance such as increased irritability, anxiety, “fuzzy thinking”, hot flashes or night sweats, or vaginal dryness, consult with an experienced menopause clinician and don’t ignore the symptoms just because you are of the “expected age” (mid 40’s and beyond!).
Thyroid: The thyroid is also called “The Master Gland” and when it is not functioning properly, many of the body’s other functions go out of kilter as well. Anxiety, weight gain, sleep disturbances and night sweats are all signs of thyroid dysfunction. It is critical that a woman experiencing these symptoms as well as hair loss, dry skin or brittle nails consult with her health care provider to determine whether the physiologic symptoms she is experiencing are due to stress (adrenal origins), menopause or abnormal thyroid function. While menopause is a natural, benign occurrence, prolonged stress and thyroid dysfunction can lead to heart disease, type II diabetes and other chronic (and potentially fatal) diseases.
Other Medical Conditions: While other medical problems may not be problematic, the medications to control them may alter metabolism and hamper weight loss efforts. Medications for high blood pressure, diabetes, arthritis or other chronic diseases often work in direct opposition to weight loss. If stringent weight loss efforts stall or appear not to work at all, it’s time to consult with your health care provider to determine if there is an underlying cause.
Weight loss is complicated but not impossible. Most women are able to achieve their weight loss goal by following a diet high in fruits, vegetables, lean proteins, whole grains and low in fat. In addition, successful “losers” exercise at a moderate intensity 3-5 times a week for 30-45 minutes each session. If these efforts are not producing the desired results, women should examine their daily schedules to see if they are under excessive stress (and excessive varies from person to person!), are eating well, able to exercise and get enough restful sleep. If all these parameters check out, it’s time to check in with a physician or other health practitioner to make sure there is no underlying physical disorder.
About Darline Turner-Lee
Darline is a physician assistant, Clinical Exercise Specialist and perinatal fitness instructor. She is also the owner and founder of Mamas on Bedrest & Beyond, a company that serves and supports high risk pregnant women and new moms. For more information or to contact Darline, visit www.mamasonbedrest.com or e-mail her at Darline@mamasonbedrest.
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