PROFESSOR TRIM’S QUICK START New Mothers 15/5/03 11:24 AM Page i PROFESSOR TRIM’S PROFESSORS Professor John Blundell PhD, C Psychol, MBPS Professor of Bio-Psychology, Leeds University, UK and Board Member of the International Association for the Study of Obesity (IASSO) Professor Wendy Brown BSc (Hons), MSc, Dip Phys Ed, PhD Professor of Physical Activity and Health, University of Queensland Professor Ian Caterson MBBS, BSc (Med), PhD, FRACP Boden Professor of Human Nutrition, Sydney University and Vice President, IASSO Professor Terry Dwyer MBBS, MPH, MD, FAFPHM Director Menzies School of Health Sciences Hobart, and University of Tasmania Professor Garry Egger MPH, PhD, MAPS Director, Centre for Health Promotion and Research Sydney Adjunct Professor of Health Sciences, Deakin University Professor James Hill PhD Director, Center for Human Nutrition, University of Colorado Health Sciences Center and Co-Founder, National Weight Control Registry Professor Kerin O’Dea BSc, PhD Director of Menzies School of Health Research, Darwin Professor Stephan Rossner MD, PhD Director, Obesity Research Program, Luddinge Hospital, Stockholm, Sweden and Past President of IASSO Professor Boyd Swinburn MD, MBChB, FRACP Professor of Population Health and Nutrition, Deakin University Professor Klaas Westerterp PhD Professor of Human Energetics, Head of Department of Human Biology, Maastricht University, The Netherlands New Mothers 15/5/03 11:24 AM Page ii PROFESSOR TRIM’S QUICK START THE WEIGHT-LOSS PROGRAM for new mothers and mothers-to-be Dr Katherine Samaris MB, BS, PhD, FRACP Dr Garry Egger MPH, PhD, MAPS New Mothers 15/5/03 11:24 AM Page iii First published in 2003 Copyright © Katherine Samaris 2003 Copyright © Garry Egger 2003 All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without prior permission in writing from the publisher. The Australian Copyright Act 1968 (the Act) allows a maximum of one chapter or 10% of this book, whichever is the greater, to be photocopied by any educational institution for its educational purposes provided that the educational institution (or body that administers it) has given a remuneration notice to Copyright Agency Limited (CAL) under the Act. Allen & Unwin 83 Alexander Street Crows Nest NSW 2065 Australia Phone: (61 2) 8425 0100 Fax: (61 2) 9906 2218 Email: info@allenandunwin.com Web: www.allenandunwin.com National Library of Australia Cataloguing-in-Publication entry: Samaris, Katherine. Egger, Garry. Quick start weight-loss program for new mothers and mothers-to-be. ISBN 1 74114 117 6. 1. Weight-loss. 2. Women–Nutrition. 3. Physical fitness for women. I. Title. (Series: Professor Trim’s medically supervised weight-loss programs). 613.7045 Set in 11/12.5 pt Adobe Garamond by Midland Typesetters, Maryborough, Victoria Printed by Griffin Press, South Australia 10987654321 New Mothers 15/5/03 11:24 AM Page iv CONTENTS Introduction How to use Professor Trim’s Quick Start Weight-Loss Program for New Mothers and Mothers-to-be vii Part 1 Background 1 Obesity and the modern environment 3 2 General nutrition for weight management 9 3 More movement makes mightier mums 20 4 Stressing up for (more) dinner 27 Part 2 Motherhood Pre-pregnancy 5 When weight gets in the way 35 Pregnancy 6 A natural process 45 7 Special nutritional requirements in pregnancy 54 8 Special considerations in pregnancy 60 Post-partum 9 Weight management after childbirth 65 10 Myths associated with pregnancy and body weight 71 Appendix Purchasing Professor Trim’s Medically Supervised Weight-Loss Programs 77 New Mothers 15/5/03 11:24 AM Page v ABOUT THE AUTHORS Garry Egger is Director of the Centre for Health Promotion and Research in Sydney and Adjunct Professor of Health Sciences at Deakin University. He has been involved in health promotion for almost 30 years and is the author of more than 25 books. Katherine Samaris is a Consultant Endocrinologist at St Vincent’s Clinic and St Vincent’s General Hospital, Sydney. She is actively involved in diabetes and obesity research at the Gavin Institute of Medical Research. New Mothers 15/5/03 11:24 AM Page vi INTRODUCTION: How to use Professor Trim’s Quick Start Weight-loss Program for New Mothers and Mothers-to-be The Professor Trim’s (PT) Quick Start program in this book is an introduction to effective weight loss, and a life- time of weight management, for new mothers and mothers- to-be. It differs from other pregnancy advice in that it’s aimed mainly at mothers—although never neglecting the health of the baby. Most information for new mums, you’ll find, is focused on the health of the child. And while no one would deny the importance of this, the ongoing health of the mother often seems to be forgotten. Pregnancy and childbirth are critical periods for weight gain in women and the weight that’s gained at these times is often difficult to lose over the long term. Since excess body weight can be a health risk, it’s crucial that all the best available scientific information be put into helping women at these stages in their life. This doesn’t mean ignoring the needs of the baby. Indeed, as we will see, maintaining ideal weight and good health in the mother is likely to improve childbirth outcomes. The Professor Trim program is designed to do just that. vii New Mothers 15/5/03 11:24 AM Page vii PROFESSOR TRIM’S—THE HISTORY Professor Trim’s evolved from the ‘GutBuster’ program, which started as a men’s ‘waist-loss’ program in 1991. GutBusters became the biggest, and most successful, men’s weight-loss program in the world. It had an inter- nationally acclaimed scientific advisory board and was consistently rated by consumer groups as among the best weight-loss programs available. Initially designed for men, GutBusters soon devel- oped a program for women. Hence the Professor Trim’s range of programs—for men and women, and these Quick Start versions. Several thousand Australian doctors (see www . professortrim.com) have had special training in weight control as part of a Postgraduate Medical Certificate in Weight Control and Obesity Management from Sydney University. These doctors, and the Professor Trim’s Medically Supervised Weight-Loss Program, can help new mums through a shared-care system that provides the best information available on weight loss and weight management. MORE PROFESSOR TRIM’S ADVICE More intensive individual programs will continue the quick start to weight loss you’ll get from this program. Information about the full Professor Trim’s programs are contained in the back of this bookset. You can also purchase these directly from your PT doctor and work with him or her through the full twelve months of the program, or longer. The way to get the greatest benefit from this Quick Start new mum’s program is first to read the book. You can then access regular updates on current research and NEW MOTHERS AND MOTHERS-TO-BE viii New Mothers 15/5/03 11:24 AM Page viii information from the Professor Trim Internet site at www .professortrim.com. At the end of each chapter in this booklet you will find an easy-to-follow summary of its contents, contained in a Professor Trim’s Prescription Pad. Use these summaries as your checklist for putting the program into action. STRUCTURE OF THE PROGRAM The information contained in this book is divided into two parts. The first part, ‘Background’, provides a summary of general weight loss information—nutrition, physical activity and stress management in particular— to set the stage for modifications to this with mother- hood. The second part, ‘Motherhood’, discusses the specific requirements for weight management before, during and after pregnancy. The reason that both the ‘before’ and ‘during’ pregnancy periods are considered so important here is that taking preventable action in these stages can make long-term weight control after childbirth much more manageable. Best results are likely to be achieved by fully preparing for weight management in the pre-pregnancy, ‘before’ phase. Since about half of all pregnancies are unplanned, however, we appreciate this is not always possible. Hence actions taken during pregnancy might represent the first attempt to deal with a weight problem. Where action is left until after delivery, the problem becomes more diffi- cult, but not impossible to solve. Women reading this who have already put on weight after giving birth should consider all of the advice as part of their preparation for any future pregnancies. For those who have finished their family, the complete Professor Trim’s ‘Becoming Slimmer’ program for women is another alternative. INTRODUCTION ix New Mothers 15/5/03 11:24 AM Page ix NEW MOTHERS AND MOTHERS-TO-BE x Professor Trim’s Prescription Pad • Read this booklet first. • Try to put the recommendations at the end of each chapter into action. • Check in at the Professor Trim Website (www .professortrim.com). • Check in with your Professor Trim doctor for ongoing help. • For more specific programs, and a ‘personal weight coach’, see the Appendix on page 77. New Mothers 15/5/03 11:24 AM Page x [...].. .New Mothers 15/5/03 11:24 AM Page 1 Part 1 Background New Mothers 15/5/03 11:24 AM Page 2 New Mothers 15/5/03 11:24 AM Page 3 Chapter 1 OBESITY AND THE MODERN ENVIRONMENT OBESITY THE MODERN EPIDEMIC Through thousands of years of evolution, humans were kept lean by the effort required either to eat or avoid being eaten The ultimate goal was comfort—food on the table at the end of the day, without... of time and effort for the past 50 years You’ll need to turn this around and think of how you can ‘waste’ physical effort in performing your daily tasks 21 New Mothers 15/5/03 11:24 AM Page 22 NEW MOTHERS AND MOTHERS- TO-BE Is it possible to take public transport? Could you get off the bus a couple of stops earlier than you have to, park the car some distance from where you are going (or leave the car... into the trap of being inactive the rest of the day to ‘compensate’) 23 New Mothers 15/5/03 11:24 AM Page 24 NEW MOTHERS AND MOTHERS- TO-BE WHAT TYPE OF MOVEMENT? The best forms of weight loss activity are those which are weight-bearing, that is, where the body’s weight is not supported, as in the water or a on a bicycle Some forms of movement are better than others But in general we can say that it’s the. .. restrictive dieting; and • Limiting rich, high energy dense foods These principles apply generally throughout the stages of motherhood, from planning a pregnancy to after delivery FOOD VOLUME AND WEIGHT LOSS Despite the hype about different types of diets for weight loss, the issue basically boils down to the volume of food 9 New Mothers 15/5/03 11:24 AM Page 10 NEW MOTHERS AND MOTHERS- TO-BE consumed... at the level of the bottom three guidelines is unlikely to be harmful and will be helpful for long-term weight maintenance Vigorous activity is not necessary except in mothers who wish to maintain a competitive level of sporting fitness, which is an area outside the scope of this booklet and requires specialised professional supervision 25 New Mothers 15/5/03 11:24 AM Page 26 NEW MOTHERS AND MOTHERS- TO-BE... can also be unlearned 7 New Mothers 15/5/03 11:24 AM Page 8 NEW MOTHERS AND MOTHERS- TO-BE • Learning new habits Replacing negative ways of thinking with more rational, positive ways of thinking, is often as good as, or better than, any diet program for weight loss Professor Trim’s Prescription Pad • • • • 8 Weight gain is normal and healthy in pregnancy—but it can be too much in the modern environment,... pregnancy, it does not need to be 15 New Mothers 15/5/03 11:24 AM Page 16 NEW MOTHERS AND MOTHERS- TO-BE increased greatly In women who are already overweight, the actual quantity of food eaten may not need to be increased at all On the other hand, it is vital that a pregnant woman does not diet, or excessively restrict her food intake Moderation is the key to a healthy pregnancy and pregnancy outcome INCREASING... energy, over the rest of the day Other factors that seem to be important, particularly for women either contemplating pregnancy or about to become mothers, are: • Unlearning old habits These often die hard, but habits such as eating for comfort, or being passive instead of active, are often the cause of significant weight problems The good news is that if they can be learned in the first place, they can... the baby afterwards To do this their bodies had to lay down extra energy reserves (i.e., fat) as a form of insurance against famine, a process which became very effective And while the trials of day-to-day life in past ages ensured that the 3 New Mothers 15/5/03 11:24 AM Page 4 NEW MOTHERS AND MOTHERS- TO-BE effects of weight gain were readily counteracted after childbirth, the easier way of life in our... becoming aware of these changes and making the necessary adjustments to reduce their impact This doesn’t mean going back to hauling water from the nearest freshwater spring or washing clothes by hand But it does mean considering a longterm plan for weight management The table below shows the factors that appear to be most associated with weight gain in new mothers and mothers- to-be Factors identified . Australia 10987654321 New Mothers 15/5/03 11:24 AM Page iv CONTENTS Introduction How to use Professor Trim’s Quick Start Weight-Loss Program for New Mothers and Mothers- to-be. Mothers 15/5/03 11:24 AM Page ii PROFESSOR TRIM’S QUICK START THE WEIGHT-LOSS PROGRAM for new mothers and mothers- to-be Dr Katherine Samaris MB, BS, PhD,