The role of postpartum weight retention in obesity among women: A review of the evidence

  • Stacy A. Gore
  • Della M. Brown
  • Delia Smith West


Young, adult women appear to be at increased risk for substantial weight gain. Pregnancy has frequently been cited as a contributor to overweight in women. This article reviews the literature examining the role of pregnancy in the development of overweight. Average postpartum weight retention ranges from 0.5 to 3 kg; however, postpartum weight retention appears to be highly variable among women, with some women retaining as much as 17.7 kg. Excessive postpartum weight retention seems to be especially prevalent among minority women. Factors such as prepregnancy weight and excessive gestational weight gain have the strongest support as risk factors for postpartum weight retention and could guide targeted intervention efforts. However, there are few controlled studies of behavioral interventions to prevent substantial pregnancy-related weight gain or postpartum weight retention. Weight loss methods successful in promoting weight control in other populations would likely also be effective with pregnant or postpartum women, although modifications for the needs of mothers may be required. Particular attention to the needs of minority mothers is warranted given the likelihood of greater weight retention in this group.


African American Woman Gestational Weight Gain Postpartum Woman Minority Woman Weight Loss Program 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. (1).
    Flegal KM, Carroll MD, Ogden CL, Johnson CL: Prevalence and trends in obesity among US adults, 1999–2000.Journal of the American Medical Association. 2002,288:1723–1727.PubMedCrossRefGoogle Scholar
  2. (2).
    Colditz GA, Willett WC, Rotnitzky A, Manson JE: Weight gain as a risk factor for clinical diabetes mellitus in women.Annals of Internal Medicine. 1995,122:481–486.PubMedGoogle Scholar
  3. (3).
    Harris TB, Ballard-Barbasch R, Madans J, Makuc DM, Feldman JJ: Overweight, weight loss, and risk of coronary heart disease in older women. The NHANES I Epidemiologic Follow-up Study.American Journal of Epidemiology. 1993,137:1318–1327.PubMedGoogle Scholar
  4. (4).
    Terry PD, Miller AB, Rohan TE: Obesity and colorectal cancer risk in women.Gut. 2002,51:191–194.PubMedCrossRefGoogle Scholar
  5. (5).
    Beckett WS, Jacobs DR Jr, Yu X, Iribarren C, Williams OD: Asthma is associated with weight gain in females but not males, independent of physical activity.American Journal of Respiratory and Critical Care Medicine. 2001,164:2045–2050.PubMedGoogle Scholar
  6. (6).
    Williamson DF, Kahn HS, Remington PL, Anda RF: The 10-year incidence of overweight and major weight gain in US adults.Archives of Internal Medicine. 1990,150:665–672.PubMedCrossRefGoogle Scholar
  7. (7).
    Rossner S, Ohlin A: Pregnancy as a risk factor for obesity: Lessons from the Stockholm Pregnancy and Weight Development Study.Obesity Research. 1995,3(Suppl. 2):267S-275S.PubMedGoogle Scholar
  8. (8).
    Greene GW, Smiciklas-Wright H, Scholl TO, Karp RJ: Postpartum weight change: How much of the weight gained in pregnancy will be lost after delivery?Obstetrics and Gynecol-ogy. 1988,71:701–707.Google Scholar
  9. (9).
    Harris HE, Ellison GT, Holliday M, Lucassen E: The impact of pregnancy on the long-term weight gain of primiparous women in England.International Journal of Obesity. 1997,21:747–755.PubMedCrossRefGoogle Scholar
  10. (10).
    Harris HE, Ellison GT, Clement S: Relative importance of heritable characteristics and lifestyle in the development of maternal obesity.Journal of Epidemiology and Community Health. 1999,53:66–74.PubMedCrossRefGoogle Scholar
  11. (11).
    Ohlin A, Rossner S: Maternal body weight development after pregnancy.International Journal of Obesity. 1990,14:159–173.PubMedGoogle Scholar
  12. (12).
    Ohlin A, Rossner S: Trends in eating patterns, physical activity and socio-demographic factors in relation to postpartum body weight development.British Journal of Nutrition. 1994,71:457–470.PubMedCrossRefGoogle Scholar
  13. (13).
    Rookus MA, Rokebrand P, Burema J, Deurenberg P: The effect of pregnancy on the body mass index 9 months postpartum in 49 women.International Journal of Obesity. 1987,11:609–618.PubMedGoogle Scholar
  14. (14).
    Williamson DF, Madans J, Pamuk E, et al.: A prospective study of childbearing and 10-year weight gain in US White women 25 to 45 years of age.International Journal of Obesity. 1994,18:561–569.PubMedGoogle Scholar
  15. (15).
    Smith DE, Lewis CE, Caveny JL, et al.: Longitudinal changes in adiposity associated with pregnancy. The CARDIA Study.Journal of the American Medical Association. 1994,271:1747–1751.PubMedCrossRefGoogle Scholar
  16. (16).
    Gunderson EP, Abrams B: Epidemiology of gestational weight gain and body weight changes after pregnancy.Epidemiologic Reviews. 2000,22:261–274.PubMedGoogle Scholar
  17. (17).
    Scholl TO, Hediger ML, Schall JI, Ances IG, Smith WK: Gestational weight gain, pregnancy outcome, and postpartum weight retention.Obstetrics and Gynecology. 1995,86:423–427.PubMedCrossRefGoogle Scholar
  18. (18).
    Subcommittee on Nutritional Status and Weight Gain During Pregnancy:Nutrition During Pregnancy. Washington, DC: Institute of Medicine, National Academy of Sciences, 1990.Google Scholar
  19. (19).
    To WW, Cheung W: The relationship between weight gain in pregnancy, birth-weight and postpartum weight retention.Australian and New Zealand Journal of Obstetrics and Gynaecology. 1998,38:176–179.PubMedCrossRefGoogle Scholar
  20. (20).
    Thorsdottir I, Birgisdottir BE: Different weight gain in women of normal weight before pregnancy: Postpartum weight and birth weight.Obstetrics and Gynecology. 1998,92:377–383.PubMedCrossRefGoogle Scholar
  21. (21).
    Gunderson EP, Abrams B, Selvin S: The relative importance of gestational gain and maternal characteristics associated with the risk of becoming overweight after pregnancy.International Journal of Obesity. 2000,24:1660–1668.PubMedCrossRefGoogle Scholar
  22. (22).
    Ohlin A, Rossner S: Factors related to body weight changes during and after pregnancy: The Stockholm Pregnancy and Weight Development Study.Obesity Research. 1996,4:271–276.PubMedGoogle Scholar
  23. (23).
    Muscati SK, Gray-Donald K, Koski KG: Timing of weight gain during pregnancy: Promoting fetal growth and minimizing maternal weight retention.International Journal of Obesity. 1996,20:526–532.PubMedGoogle Scholar
  24. (24).
    Soltani H, Fraser RB: A longitudinal study of maternal anthropometric changes in normal weight, overweight and obese women during pregnancy and postpartum.British Journal of Nutrition. 2000,84:95–101.PubMedGoogle Scholar
  25. (25).
    Schauberger CW, Rooney BL, Brimer LM: Factors that influence weight loss in the puerperium.Obstetrics and Gynecology. 1992,79:424–429.PubMedCrossRefGoogle Scholar
  26. (26).
    Lu MC, Lange L, Slusser W, Hamilton J, Halfon N: Provider encouragement of breast-feeding: Evidence from a national survey.Obstetrics and Gynecology. 2001,97:290–295.PubMedCrossRefGoogle Scholar
  27. (27).
    Parker JD, Abrams B: Differences in postpartum weight retention between Black and White mothers.Obstetrics and Gynecology. 1993,81:768–774.PubMedGoogle Scholar
  28. (28).
    Dewey KG, Cohen RJ, Brown KH, Rivera LL: Effects of exclusive breastfeeding for four versus six months on maternal nutritional status and infant motor development: Results of two randomized trials in Honduras.Journal of Nutrition. 2001,131:262–267.PubMedGoogle Scholar
  29. (29).
    Janney CA, Zhang D, Sowers M: Lactation and weight retention.American Journal of Clinical Nutrition. 1997,66:1116–1124.PubMedGoogle Scholar
  30. (30).
    Dewey KG, Heinig MJ, Nommsen LA: Maternal weight-loss patterns during prolonged lactation.American Journal of Clinical Nutrition. 1993,58:162–166.PubMedGoogle Scholar
  31. (31).
    Wright AL: The rise of breastfeeding in the United States.Pedi-atric Clinics of North America. 2001,48:1–12.CrossRefGoogle Scholar
  32. (32).
    Keppel KG, Taffel SM: Pregnancy-related weight gain and retention: Implications of the 1990 Institute of Medicine guidelines.American Journal of Public Health. 1993,83:1100–1103.PubMedGoogle Scholar
  33. (33).
    Boardley DJ, Sargent RG, Coker AL, Hussey JR, Sharpe PA: The relationship between diet, activity, and other factors, and postpartum weight change by race.Obstetrics and Gynecology. 1995,86:834–838.PubMedCrossRefGoogle Scholar
  34. (34).
    Jeffery RW, Drewnowski A, Epstein LH, et al.: Long-term maintenance of weight loss: Current status.Health Psychology. 2000,19:5–16.PubMedCrossRefGoogle Scholar
  35. (35).
    Algert S, Shragg P, Hollingsworth DR: Moderate caloric restriction in obese women with gestational diabetes.Obstetrics and Gynecology. 1985,65:487–491.PubMedGoogle Scholar
  36. (36).
    Polley B, Wing R, Meier A, Sims C, DeBranski C: Preventing excessive weight gain during pregnancy in overweight and normal weight women.Annals of Behavioral Medicine. 1997,19:S071.Google Scholar
  37. (37).
    Ogunyemi D, Hullett S, Leeper J, Risk A: Prepregnancy body mass index, weight gain during pregnancy, and perinatal outcome in a rural Black population.Journal of Maternal-Fetal Medicine. 1998,7:190–193.PubMedCrossRefGoogle Scholar
  38. (38).
    Rossner S, Ohlin A: Maternal body weight and relation to birth weight.Acta Obstetrica et Gynecologica Scandinavica. 1990,69:475–478.CrossRefGoogle Scholar
  39. (39).
    Clapp JF III: The effects of maternal exercise on early pregnancy outcome.American Journal of Obstetrics and Gynecology. 1989,161:1453–1457.PubMedGoogle Scholar
  40. (40).
    Clapp JF III: Morphometric and neurodevelopmental outcome at age five years of the offspring of women who continued to exercise regularly throughout pregnancy.Journal of Pediatrics. 1996,129:856–863.PubMedCrossRefGoogle Scholar
  41. (41).
    Wing R: Behavioral weight control. In Wadden T, Stunkard A (eds),Handbook of Obesity Treatment. New York: Guilford Press, 2002, 301–316.Google Scholar
  42. (42).
    Baker CW, Carter AS, Cohen LR, Brownell KD: Eating attitudes and behaviors in pregnancy and postpartum: Global stability versus specific transitions.Annals of Behavioral Medicine. 1999,21:143–148.PubMedGoogle Scholar
  43. (43).
    Dewey KG, Lovelady CA, Nommsen-Rivers LA, McCrory MA, Lonnerdal B: A randomized study of the effects of aerobic exercise by lactating women on breast-milk volume and composition.New England Journal of Medicine. 1994,330:449–453.PubMedCrossRefGoogle Scholar
  44. (44).
    McCrory MA, Nommsen-Rivers LA, Mole PA, Lonnerdal B, Dewey KG: Randomized trial of the short-term effects of dieting compared with dieting plus aerobic exercise on lactation performance.American Journal of Clinical Nutrition. 1999,69:959–967.PubMedGoogle Scholar
  45. (45).
    Lovelady CA, Garner KE, Moreno KL, Williams JP: The effect of weight loss in overweight, lactating women on the growth of their infants.New England Journal of Medicine. 2000,342:449–453.PubMedCrossRefGoogle Scholar
  46. (46).
    Leermakers EA, Anglin K, Wing RR: Reducing postpartum weight retention through a correspondence intervention.International Journal of Obesity. 1998,22:1103–1109.PubMedCrossRefGoogle Scholar
  47. (47).
    Strode MA, Dewey KG, Lonnerdal B: Effects of short-term caloric restriction on lactational performance of well-nourished women.Acta Paediatrica Scandinavica. 1986,75:222–229.PubMedCrossRefGoogle Scholar
  48. (48).
    Perri MG, Nezu AM, Patti ET, McCann KL: Effect of length of treatment on weight loss.Journal of Consulting and Clinical Psychology. 1989,57:450–452.PubMedCrossRefGoogle Scholar
  49. (49).
    Klem ML, Viteri JE, Wing RR: Primary prevention of weight gain for women aged 25–34: The acceptability of treatment formats.International Journal of Obesity. 2000,24:219–225.PubMedCrossRefGoogle Scholar
  50. (50).
    Simkin-Silverman LR, Wing RR, Boraz MA, Meilahn EN, Kuller LH: Maintenance of cardiovascular risk factor changes among middle-aged women in a lifestyle intervention trial.Women’s Health. 1998,4:255–271.PubMedGoogle Scholar
  51. (51).
    Walker LO: Weight and weight-related distress after childbirth: Relationships to stress, social support, and depressive symptoms.Journal of Holistic Nursing. 1997,15:389–405.PubMedCrossRefGoogle Scholar
  52. (52).
    Harris HE, Ellison GT, Clement S: Do the psychosocial and behavioral changes that accompany motherhood influence the impact of pregnancy on long-term weight gain?Journal of Psychosomatic Obstetrics and Gynaecology. 1999,20:65–79.PubMedCrossRefGoogle Scholar
  53. (53).
    Wolfe WS, Sobal J, Olson CM, Frongillo EA Jr, Williamson DF: Parity-associated weight gain and its modification by sociodemographic and behavioral factors: A prospective analysis in US women.International Journal of Obesity. 1997,21:802–810.PubMedCrossRefGoogle Scholar
  54. (54).
    Gunderson EP, Abrams B: Epidemiology of gestational weight gain and body weight changes after pregnancy.Epidemiologic Reviews. 1999,21:261–275.PubMedGoogle Scholar

Copyright information

© The Society of Behavioral Medicine 2003

Authors and Affiliations

  • Stacy A. Gore
    • 1
  • Della M. Brown
    • 1
  • Delia Smith West
    • 1
  1. 1.University of Alabama at BirminghamUK

Personalised recommendations