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Is it OK for me to gain back weight I'd lost?
Q: Last year I lost 75 pounds by cutting sugar and carbohydrates from my diet. Now I'm six months pregnant and have gained 30 pounds. My doctor is concerned that the baby and I will gain too much.

I get the nutrition I need but have added sugar and carbohydrates back into my diet. That's why the weight is coming back quickly, but it's hard to watch what I eat. Because I lost so much before pregnancy is it okay for me to be gaining it back now? Also, because I lost the weight so fast before, do you think it will come off as easily after pregnancy with a better diet and breastfeeding?
A: It must be frustrating to be gaining weight rapidly after your successful experience with weight loss. Your body may be particularly sensitive to carbohydrates. Unless you were dramatically underweight before the pregnancy, it's probably not a great idea to gain weight so quickly during your pregnancy, particularly if your weight gain is the result of consuming sugar and refined carbohydrates. It sounds like you will need to find a new balance, and I recommend that you consult with a dietician.

Although it is hard for you to watch what you eat, I recommend eliminating sugary foods and refined carbohydrates (such as white bread or pasta) from your diet. If you cut out sugary foods for a week, you will likely lose your cravings for these. Emphasize vegetables and proteins in your diet, eat whole grain carbohydrates (like whole wheat bread and brown rice) and choose low fat dairy products. You can eat fruit, but avoid relying on fruit juices or fruit drinks, which are loaded with calories. One option is to resume your low carbohydrate diet for two meals a day, and eat with fewer restrictions for one meal a day. A dietician will review your dietary options in detail and find a balance you can live with. Also, be sure to include exercise in your daily routine if your doctor permits this.

As for breastfeeding, I encourage you to maintain a healthy diet while lactating. Breastfeeding will help you burn about 500 extra calories a day. However, you will still need a nutritious, balanced diet. If you focus on proteins, vegetables, fruits, low-fat dairy, and some healthy fats (such as from nuts and olive oil), and continue to stay active while you care for your baby, you will head towards an optimal weight and a healthy body.

Laura E. Stachel M.D. Obstetrician & Gynecologist