MDNews - Greater Kansas

++ + ++ + OBESITY AND PREGNANCY: The Bariatrician’s Role By Jeannine M. Cobb, M.D., FACOG, Diplomate of the American Board of Bariatric Medicine THE NUMBER OF obese pregnant women has increased dramatically, along with the overall rate of obesity in our country. This fact threatens to exacerbate the obesity crisis. Recent research has proven that obesity and poor nutrition of a mother during pregnancy can literally cause fetal imprinting of the levels of feeding and satiety hormones that may affect the child for its lifetime and place the child at greater risk for childhood and adult obesity. In an effort to reverse this trend, the American Congress of Obstetricians and Gynecologists (ACOG) and the Institute of Medicine (IOM) have issued specific recom- mendations that call for proper levels of macronutrients (protein and carbohydrates), prevention of ketosis, adequate hydration with proper fluids, and appropriate vitamin and mineral supplementation (Omega-3, multivita- mins, minerals and other micronutrients). Most expecting mothers are younger women with little knowledge of these matters who have shown only sporadic interest in their own nutri- tion. Their dietary habits likely consist of calorie counting without attention to macronutrient or micronutrient content. Thus, the task of educating these women on proper nutrition during pregnancy and implementation of a plan is a nearly impossible task, especially for the busy OB/GYN or primary care physician. Luckily, pregnancy is a time when women are generally motivated to change their lifestyles in an effort to help their fetuses. I have personally observed many women who, after learning the devastating effects of smoking, drugs and alcohol during pregnancy, have immediately stopped these behaviors. Pregnancy certainly presents a teachable moment in the lives of mothers, and as health care providers, we must take advantage of this moment. The bariatrician is uniquely qualified to join the medical team assisting the obese pregnant woman. The certification process requires bariatri- cians to understand not only obesity and nutrition, but also how weight and nutrition interface with every phase of life and every MDNEWS.COM  MD NEWS Greater Kansas | 9 comorbidity of patients. Knowing that food is truly the most important drug we give our patients during pregnancy, the bariatrician can devise a plan that combines food with supplements and meets the strict guidelines recommended by the ACOG and the IOM. The plan can then be implemented and monitored by the bariatrician with reports and updates to the OB/GYN or primary care physician. +++++++++++++++++  BARIATRICS I encourage every physician who is dealing with a pregnant woman to take advantage of the skills and knowledge of a bariatrician to help the fetus avoid the long-term effects of the mother’s obesity. ++++++++++++++++ + + + n F D s u s n t ; n n C r o A 1r 0 c s a ” 2, 0 o o G da e h P i l r u ,r ” n , e o e m n I c i e P t o g s r i R a m i np y A o E G s e e c m i n d e m i R s se bb O O : H L c y t e t ei t i n , G eu ai r e d c l e d m e c s s a t s rp e u st h a n o 5 t W 9 g o - 1 fi a o t e g e i c n i i a ; l 0 P c 1 i 2 n , 1 g d n C 0 e w 2 i R pl p , r k 5 L 5o ; c n f o “ c J n n a d . n yf : e n W y B i c M , e a r o r R i D i n o d m e i a e n : h t x e N t t n c C g d w i o a / a G h i n , s n t ni a e n n W t l e g a “ e h i e g m i h t i o l N ia o n t a e

• Cover