Does Partial Meal Replacement During Pregnancy Reduce 12‐Month Postpartum Weight Retention?

Abstract

Objective: This randomized trial tested whether a behavioral intervention with meal replacements in pregnancy could increase the proportion of women who returned to prepregnancy weight and reduce postpartum weight retention by 12 months after delivery. Methods: Women (N = 264; 13.7 weeks' gestation) with overweight or obesity were randomly assigned to usual care or intervention. The intervention reduced excess gestational weight gain and was discontinued at delivery. At follow-up, 83.7% completed the 12-month assessment. Results: Compared with usual care, prenatal intervention had no significant effect on odds of achieving prepregnancy weight (38/128 [29.7%] vs. 41/129 [31.8%]; P = 0.98) or in reducing the magnitude of weight retained (3.3 vs. 3.1 kg; P = 0.82) at 12 months. After delivery, significant (P < 0.0001) declines in meal replacements, practice of weight control behaviors, and dietary restraint were observed in the intervention group. Independent of group, lower gestational weight gain was the strongest predictor of achieving prepregnancy weight at 12 months (P = 0.0008). Conclusions: A prenatal behavioral intervention with meal replacements that reduced pregnancy weight gain had no significant effect on 12-month postpartum weight retention.

Patterns of Weight Change One Year after Delivery Are Associated with Cardiometabolic Risk Factors at Six Years Postpartum in Mexican Women

“…To date, different prenatal weight management interventions have been successful in reducing GWG but not weight one year after delivery [53][54][55]. One reason for this may be that, as shown in this study, postpartum weight not only consists of weight retained from pregnancy but also weight gain that originates during the postpartum period.…”

Eating behaviors in relation to gestational weight gain and postpartum weight retention: A systematic review

“…The original Three-Factor Eating Questionnaire (TFEQ) has subscales on dietary restraint, disinhibition, and hunger 53 and was used either fully or partially by eight studies. 33,37,[39][40][41][42]44,45 The revised 18-item TFEQ (TFEQ-R18) consists of subscales on cognitive restraint, uncontrolled eating, and emotional eating 11 and was used by one study. 38 The Dutch Eating Behavior Questionnaire (DEBQ) comprises restrained eating, emotional eating, and external eating subscales 49 and was fully or partially used by three studies.…”

“…32,35,39,40,47,48 Neither of the RCT's had blinded participants and providers to treatment group assignment, but this was not possible due to the nature of a lifestyle intervention. 44,45 Six studies did not use validated questionnaires, or changed the wordings of questionnaires, which could therefore no longer be regarded as validated. 37,42,46,51,54,58 In one study, participants were not representative of the target population, since all participants had overweight or obesity, whereas this was not specifically the target population of the study.…”

“…Prepregnancy BMI and GWG were not adjusted for. 44 RCT that aimed to limit GWG. However, in this study, no relationship between PPWR and restrained eating was found at six and twelve months after delivery.…”

Reducing Postpartum Weight Retention and Interpregnancy Weight Gain, an Important Goal Not Yet Realized

“…Seven of these trials are part of the Lifestyle Interventions for Expectant Moms (LIFE‐Moms) consortium, a collaborative group evaluating the effect of behavioral and lifestyle interventions among pregnant women with overweight and obesity . In this month’s issue of Obesity , Phelan and colleagues present the 1‐year postpartum maternal outcomes from the Healthy Beginnings/Comienzos Saludables trial. This high‐quality study was novel in that it paired traditional behavioral weight management intervention techniques with the use of meal replacements during pregnancy.…”