PCOS, Pregnant and Terrified of Gaining Weight

kamakazeekim

In a recent study, researchers found that women without PCOS needed roughly 1868 calories per day whilst women with PCOS only needed around 1445 calories per day, and those with insulin resistance (like me) needed even less.

This means that women with PCOS do not need as many calories per day as the average women as metabolism is much slower in women with PCOS. It doesn’t seem very fair, does it? We don’t need as many calories as the average woman but we fight fierce cravings and tend to feel hungry all the time. What’s up with that?

I'm currently 6 weeks pregnant and my doctor wants me to eat 2000 calories a day. I will blow up like a freakin balloon eating like that! I gain weight when I eat more than 1000 calories a day (yes, this was medically recognized after I had weight loss surgery) I know some weight gain is inevitable during pregnancy but I don't want to gain an excessive amount!

Anyone have a realistic idea of what I should eat?

NobodyPutsAmyInTheCorner

Err I have PCOS and am currently losing weight eating 1500 calories a day. I maintain around 2000.

ManiacalLaugh

First - congrats!

Second - Is there any way you can enlist the help of a licensed and degreed dietician who is familiar with some of these medical conditions? (Stressing: NOT A NUTRITIONIST. Those guys just have to take a two hour class and pass a test)

A dietician who knows about these conditions (or at least knows where to find credible, reliable information about them) will be able to help you manage the interplay of your calorie allotment and everything you have going on. There are a lot of people here with PCOS, a lot with insulin resistance, and a lot who have been pregnant, but the mix of all three may be rare, and even then, they will likely have had a different experience than you. You might get some good suggestions, but they might not be what's actually best for you in this context.

IMO - if it weren't for your other medical conditions, I'd say eat more, acknowledge that you're going to gain, and then lose after the baby's born, just so you can make sure you're getting the proper nutrition your baby needs. But without having a medical degree, I couldn't say that with absolute certainty.

jemhh

First, this is the study that you are talking about. Note the following:

RESULT(S): Adjusted BMR was 1,868 +/- 41 kcal/day in the control group, 1,445.57 +/- 76 in all PCOS women, 1,590 +/- 130 in PCOS women without IR and 1,116 +/- 106 in PCOS women with IR. Adjusted BMR showed a statistically significant difference between women with PCOS and control subjects, with lowest values in the group of PCOS women with IR, even after adjusting all groups for age and BMI.

They are talking about BMR, not TDEE. Eating 2000 calories per day doesn't mean that you are eating 555 calories over your total caloric needs. It would mean that you are eating 555 calories more than needed for the average PCOS woman (in that study) to be alive and in a coma, doing nothing all day long.

Second, you have lost a lot of weight so I am guessing that you have a good idea of the number of calories needed to maintain that weight. Have you discussed your current calorie level with your doctor and did s/he base the recommendation of 2000 calories on that?

3AAnn3

kamakazeekim wrote: »

In a recent study, researchers found that women without PCOS needed roughly 1868 calories per day whilst women with PCOS only needed around 1445 calories per day, and those with insulin resistance (like me) needed even less.

This means that women with PCOS do not need as many calories per day as the average women as metabolism is much slower in women with PCOS. It doesn’t seem very fair, does it? We don’t need as many calories as the average woman but we fight fierce cravings and tend to feel hungry all the time. What’s up with that?

I'm currently 6 weeks pregnant and my doctor wants me to eat 2000 calories a day. I will blow up like a freakin balloon eating like that! I gain weight when I eat more than 1000 calories a day (yes, this was medically recognized after I had weight loss surgery) I know some weight gain is inevitable during pregnancy but I don't want to gain an excessive amount!

Anyone have a realistic idea of what I should eat?

I have PCOS. I've had 3 babies. It can be really hard to lose, but the cleaner my diet is and the more I work-out and eliminate stress, the more my symptoms disappear and I can lose with more ease. You can reverse many, if not all of your symptoms.

Krystle1984

My friend is a midwife and she says you only need to increase calories by 200 a day, and only for the last 3 months of pregnancy. Those are the current guidelines in the UK. The first 6 months you should eat at maintenance.

This advice is of course aimed at women who don't have PCOS or IR. Speak to your doctor about your concerns and move forward from there.

Oh - and congrats!

WeddedBliss1992

i would listen to your dr. s/he knows best about your particular situation. i have been pregnant more times than i care to count, and i gained alot of weight each time, but it is worth it. your baby needs calories to grow. this is the one time in life where you really needn't worry about caloric intake. i'm not saying to eat donuts all day, but eating a healthy 2000 calories per day will feed you and your baby well. congrats, by the way!

MamaBirdBoss

kamakazeekim wrote: »

In a recent study, researchers found that women without PCOS needed roughly 1868 calories per day whilst women with PCOS only needed around 1445 calories per day, and those with insulin resistance (like me) needed even less.

This means that women with PCOS do not need as many calories per day as the average women as metabolism is much slower in women with PCOS. It doesn’t seem very fair, does it? We don’t need as many calories as the average woman but we fight fierce cravings and tend to feel hungry all the time. What’s up with that?

I'm currently 6 weeks pregnant and my doctor wants me to eat 2000 calories a day. I will blow up like a freakin balloon eating like that! I gain weight when I eat more than 1000 calories a day (yes, this was medically recognized after I had weight loss surgery) I know some weight gain is inevitable during pregnancy but I don't want to gain an excessive amount!

Anyone have a realistic idea of what I should eat?

First, the list above is nonsense.

Second, you need to increase caloric take ON AVERAGE 20 calories a day in the first trimester, 160 calories a day in the second, and 360 the third above your maintenance, according to the WHO. This isn't a flat number. It's lower at the beginning of the trimester and higher at the end.

MamaBirdBoss

Also, your doctor is clueless to declare that everyone needs the same amount of calories at ANY time in their lives. People have different heights, weights, and activity levels.

liekewheeless

You definitely want to make sure the baby is getting enough nutrition. However the 2000 cal sounds like a very standard number and your circumstances are not standard.

Is this your Obgyn or your family doctor who recommends this amount? (or are they the same person). See if you can get in with a doctor who specializes in or at the very least is up to date on PCOS. No doctor knows everything about everything. They may be able to advice you better and also explain why you need to do something and what the consequences will be. (weight gain/babies health/your health).

Gaining during pregnancy is normal (20-40 or so pounds). But gaining an excessive amount can have it's own health problems besides having to lose it later.

MamaBirdBoss

24-30 is ideal according to the world health organization for non-overweight women. Their recommendations line up better with actual studies than the CDC's.

azulvioleta6

MamaBirdBoss wrote: »

Also, your doctor is clueless to declare that everyone needs the same amount of calories at ANY time in their lives. People have different heights, weights, and activity levels.

Yeah, that doesn't make a lot of sense. There is a lot of new information out about how women should be eating in pregnancy--new guidelines suggest that overweight women should maintain weight and can even continue to lose while pregnant.

You may not need ANY extra calories this early in your pregnancy.

A couple of articles to check out...they might not quite apply to your situation, but they could give some additional information:

opb.org/radio/programs/thinkoutloud/segment/study-shows-overweight-pregnant-women-can-safely-lose-weight/

nytimes.com/2015/03/29/opinion/sunday/pregnant-obese-and-in-danger.html?_r=0

WeddedBliss1992

after giving advice myself, i just realized this is a very wrong place to ask about pregnancy nutrition. i used to be a doula, breastfeeding consultant, childbirth educator and midwife in training. ASK A DR. NOT MFP.

jemhh

I don't see where her doctor said that all pregnant women should eat 2000 calories per day. She said that her doctor wanted her eating 2000 calories. We have no idea how her doctor came up with that number and considering the OP's complete misstatement of the PCOS BMR study, I'm a bit leery of jumping to the conclusion that the OP really asked him/her for details on the number.

azulvioleta6

WeddedBliss1992 wrote: »

after giving advice myself, i just realized this is a very wrong place to ask about pregnancy nutrition. i used to be a doula, breastfeeding consultant, childbirth educator and midwife in training. ASK A DR. NOT MFP.

Sure, but ask a doctor who knows what s/he is talking about. In the OPs situation, I would be looking for a better physician.

zdyb23456

WeddedBliss1992 wrote: »

i would listen to your dr. s/he knows best about your particular situation. i have been pregnant more times than i care to count, and i gained alot of weight each time, but it is worth it. your baby needs calories to grow. this is the one time in life where you really needn't worry about caloric intake. i'm not saying to eat donuts all day, but eating a healthy 2000 calories per day will feed you and your baby well. congrats, by the way!

I agree with this. I wouldn't say go crazy with eating anything/everything/eating for 2, but cutting calories and dieting doesn't seem like a good idea when pregnant. I'd rather a healthy, happy pregnancy = healthy baby than risk anything else even if it means gaining a few extra pounds.

Besides, eating whatever/whenever without regard to loosing weight was the best part of being pregnant for me It's the only time I was happy with being overweight!

You have the rest of your life to diet and lose weight.

WeddedBliss1992

azulvioleta6 wrote: »

WeddedBliss1992 wrote: »

after giving advice myself, i just realized this is a very wrong place to ask about pregnancy nutrition. i used to be a doula, breastfeeding consultant, childbirth educator and midwife in training. ASK A DR. NOT MFP.

Sure, but ask a doctor who knows what s/he is talking about. In the OPs situation, I would be looked for a better physician.

what in the OP says that the dr's advice is wrong or off?

azulvioleta6

WeddedBliss1992 wrote: »

azulvioleta6 wrote: »

WeddedBliss1992 wrote: »

after giving advice myself, i just realized this is a very wrong place to ask about pregnancy nutrition. i used to be a doula, breastfeeding consultant, childbirth educator and midwife in training. ASK A DR. NOT MFP.

Sure, but ask a doctor who knows what s/he is talking about. In the OPs situation, I would be looked for a better physician.

what in the OP says that the dr's advice is wrong or off?

The fact that it doesn't match the newer research in this area.

Blindly acquiescing to a doctor's opinion is ridiculous. Doctors are human and they make mistakes. Some are much better informed than others. Some stay up-to-date, others do not.

If what a doctor is telling you to do doesn't make sense, look for a better doctor.

WeddedBliss1992

newer research doesn't necessarily equal better. my last OB was over 70 years old and had been delivering babies since he was in his 20's. he even used a fetascope instead of a modern electronic version to listen to baby's heartbeat. just because something is new doesn't mean it is better. and if the OP goes into the dr's office and gives the dr every single bit of information she has about herself, then that is just all the more the dr should be trusted. i didn't read anything in the OP that said what the dr was advising "didn't make sense." i think what makes even less sense is coming onto a public forum and listening to a bunch of strangers when it comes to the health of your unborn child.

kshama2001

I agree with you in general but why people are taking exception to her doctor is because he/she wants the OP to double her calories:

my doctor wants me to eat 2000 calories a day. I will blow up like a freakin balloon eating like that! I gain weight when I eat more than 1000 calories a day (yes, this was medically recognized after I had weight loss surgery)

WeddedBliss1992

kshama2001 wrote: »

I agree with you in general but why people are taking exception to her doctor is because he/she wants the OP to double her calories:

my doctor wants me to eat 2000 calories a day. I will blow up like a freakin balloon eating like that! I gain weight when I eat more than 1000 calories a day (yes, this was medically recognized after I had weight loss surgery)

that is why i was wondering if she told dr EVERYTHING? does dr know about weight loss surgery? does dr know that she can't comfortably eat more than 1000 cal/day? giving the dr information is more than half the battle in finding a good dr.

jemhh

I'm not convinced of the claim that she gains weight eating more than 1000 calories. Her food diary is sporadic at best and on the days when she does log (mid April) she's more in the 1300 calorie range.

kamakazeekim

Yep I was in the 1300 calorie range while trying to get pregnant because my doctor thought I was eating too little to ovulate. I gained weight eating the 1300 calories (although it was a very slow gain) My doctor does know about my WLS and that I struggle to eat more than 1300 calories (when trying to get pregnant I was supposed to be eating at least 1600 calories) which is why they want me to to drink ensure or other such calorie dense nutrition drinks. I'm 5'3 and 127 pounds. After having my 2nd baby and doing everything EXACTLY as I was told to do I was 263 pounds. No doctor or dietitian could tell me why I gained such an outrageous amount so fast so they assumed I was lying about what I ate and how much I worked out. That's why I got the WLS. After the WLS I continued to not lose weight. I saw yet another endocrinologist who put me on metformin at the maximum dose and I finally for the first time in my life lost weight as long as I kept my calories at 1000 or less and my carbs low.

Sued0nim

TDEEs don't work like that - they are relatively bespoke to the individual

jemhh wrote: »

First, this is the study that you are talking about. Note the following:

RESULT(S): Adjusted BMR was 1,868 +/- 41 kcal/day in the control group, 1,445.57 +/- 76 in all PCOS women, 1,590 +/- 130 in PCOS women without IR and 1,116 +/- 106 in PCOS women with IR. Adjusted BMR showed a statistically significant difference between women with PCOS and control subjects, with lowest values in the group of PCOS women with IR, even after adjusting all groups for age and BMI.

They are talking about BMR, not TDEE. Eating 2000 calories per day doesn't mean that you are eating 555 calories over your total caloric needs. It would mean that you are eating 555 calories more than needed for the average PCOS woman (in that study) to be alive and in a coma, doing nothing all day long.

Second, you have lost a lot of weight so I am guessing that you have a good idea of the number of calories needed to maintain that weight. Have you discussed your current calorie level with your doctor and did s/he base the recommendation of 2000 calories on that?

this ^^^

Sued0nim

WeddedBliss1992 wrote: »

newer research doesn't necessarily equal better. my last OB was over 70 years old and had been delivering babies since he was in his 20's. he even used a fetascope instead of a modern electronic version to listen to baby's heartbeat. just because something is new doesn't mean it is better. and if the OP goes into the dr's office and gives the dr every single bit of information she has about herself, then that is just all the more the dr should be trusted. i didn't read anything in the OP that said what the dr was advising "didn't make sense." i think what makes even less sense is coming onto a public forum and listening to a bunch of strangers when it comes to the health of your unborn child.

You had a 70 year old doctor who didn't keep up with the latest medical knowledge and used outdated equipment which is their duty, and you are proud of that?

I am so imagining a Pinard Horn here :bigsmile:

Ninkyou

kamakazeekim wrote: »

Yep I was in the 1300 calorie range while trying to get pregnant because my doctor thought I was eating too little to ovulate. I gained weight eating the 1300 calories (although it was a very slow gain) My doctor does know about my WLS and that I struggle to eat more than 1300 calories (when trying to get pregnant I was supposed to be eating at least 1600 calories) which is why they want me to to drink ensure or other such calorie dense nutrition drinks. I'm 5'3 and 127 pounds. After having my 2nd baby and doing everything EXACTLY as I was told to do I was 263 pounds. No doctor or dietitian could tell me why I gained such an outrageous amount so fast so they assumed I was lying about what I ate and how much I worked out. That's why I got the WLS. After the WLS I continued to not lose weight. I saw yet another endocrinologist who put me on metformin at the maximum dose and I finally for the first time in my life lost weight as long as I kept my calories at 1000 or less and my carbs low.

IMO you should be listening to your doctor. He/she knows your situation. Pregnancy is not the time to skimp on calories. Of course that doesn't mean you have to "eat for two" or go out of control. It does mean, however, that you need to provide YOUR body and your BABY adequate nutrition. It's not just about you and your weight loss anymore.

I lost 57 lbs before I got pregnant with my baby. I was concerned about weight gain too. I logged everything I ate. If I went over, I went over. But I still had that accountability and I didn't really go over all that often. I'm 5'2 and was 155 prepregnancy. I started somewhere around 1700-1800 calories in my first trimester and ended somewhere around 2200-2400 in my third. I gained my recommended amount according to my BMI, which was 25 lbs. I gained 24.6 lbs, lol. 2000 calories seems like it's just been streamlined by your doctor to shoot for for your entire pregnancy, rather than adding throughout the trimesters. That's my interpretation at least. Which is actually pretty reasonable.

So yeah, I think you should listen to your doctor. Maybe start logging consistently on MFP too. You can always ask your OB to refer you to a dietician that specializes in pregnancy nutrition. But stay where you are, 1000-1300 calories (especially when you were specifically told to eat 1600) isn't what you should do.

Relax about the weight gain. It's going to happen, whether you will it to or not. Remember that you can always lose weight after baby. But right now, there are more important things than some perceived attachment to keeping your numbers low or whatever.

jemhh

Why not eat at the caloric level recommended by the medical professional who knows your case and then, if you suddenly "blow up like a freakin balloon" eat a bit less? You will not literally gain 5 or 10 or 20 pounds overnight if you are paying attention to the scale and how your clothes fit. You're not going to eat 2000 calories today, go to bed, and wake up 200 pounds in the morning.

busyPK

Congrats on the pregnancy! I've had 3 kids and my only advise is to listen to your body. Eat when you are hungry, stay hydrated and don't put so much value on the number listed on the scale. If it affects you so much, then turn around when they weigh you and ask them to not tell you. You are growing a baby!! If you were able to lose weight in the past then you can do it again once you delivery and recover.

kamakazeekim

jemhh wrote: »

Why not eat at the caloric level recommended by the medical professional who knows your case and then, if you suddenly "blow up like a freakin balloon" eat a bit less? You will not literally gain 5 or 10 or 20 pounds overnight if you are paying attention to the scale and how your clothes fit. You're not going to eat 2000 calories today, go to bed, and wake up 200 pounds in the morning.

I do gain weight crazy fast though! I was out of refills on my medication and it took almost 3 weeks to get a new prescription and in that time I gained almost 12 pounds. My eating did not change at all during that time.

Ninkyou

kamakazeekim wrote: »

jemhh wrote: »

Why not eat at the caloric level recommended by the medical professional who knows your case and then, if you suddenly "blow up like a freakin balloon" eat a bit less? You will not literally gain 5 or 10 or 20 pounds overnight if you are paying attention to the scale and how your clothes fit. You're not going to eat 2000 calories today, go to bed, and wake up 200 pounds in the morning.

I do gain weight crazy fast though! I was out of refills on my medication and it took almost 3 weeks to get a new prescription and in that time I gained almost 12 pounds. My eating did not change at all during that time.

I'm really skeptical of this, to be honest. Mathematically and scientifically that makes no sense. You would have had to eaten about 42,000 extra calories over what you need to maintain to gain 12 lbs. Yet your eating didn't change. That's literally not possible.

To be honest, I feel like there's a lot of inconsistency going on here. You haven't logged since late April, and even that was inconsistent. I see you also do not weigh your food, so I suspect you are actually eating more calories than you think. But even that would not account for an extra 42,000 calories. Do you understand what I'm getting at here?

Your (non-pregnancy) gains are probably a mixture water, hormones and inaccurate calorie intake. You did not just magically gain 12 lbs.

Your pregnancy gains are going to be baby, placenta, blood, maternal fat stores, milk production, water, hormones, etc. Your gains should be pretty consistent with a few large upshoots from "growth spurts".

Seriously, stop freaking out about weight gain. It's going to happen. You can keep it in check though by logging consistently and accurately.
Also, eat more than 1000 calories. How do you expect to grow a baby with that? You can't. I'm assuming you worked hard to even get pregnant, so why would you risk your pregnancy and baby by ignoring your doctor's advice and only eating 1000 calories? Do you think 1000 or even 1300 calories is enough to grow a healthy baby? Because it's not.

jemhh

kamakazeekim wrote: »

jemhh wrote: »

Why not eat at the caloric level recommended by the medical professional who knows your case and then, if you suddenly "blow up like a freakin balloon" eat a bit less? You will not literally gain 5 or 10 or 20 pounds overnight if you are paying attention to the scale and how your clothes fit. You're not going to eat 2000 calories today, go to bed, and wake up 200 pounds in the morning.

I do gain weight crazy fast though! I was out of refills on my medication and it took almost 3 weeks to get a new prescription and in that time I gained almost 12 pounds. My eating did not change at all during that time.

Unless your medication is something that causes you to pass food without any nutrient absorption, I don't believe you. Your incomplete diary and your blog seem very off to me.