weight gain
1. premenstrual. Many women regularly gain several pounds during the week pre- ceding their menstrual period. This gain is nearly always the result of fluid retention (sometimes com- bined with constipation) and somewhat increased appetite, and it disappears during the first few days of menstrual flow. (See also DYSMENORRHEA, def. 5.) The same phenomenon may occur in women taking oral contraceptives; the higher hormone levels seem to cause fluid retention and sometimes increased appetite, manifested in weight gain.
2. in pregnancy. Weight gain is both normal and necessary during pregnancy. From the 1930s to the early 1960s American women frequently were advised to limit their weight gain during preg- nancy to 10 to 15 pounds (4½ to 7 kilos), in the belief that it would ease labor and delivery, prevent hypertension and preeclampsia and help maintain an attractive figure. However, some investigators began to observe that the salt-poor, often protein-deficient diets used to restrict weight gain in pregnancy actually could be harmful, producing smaller, less healthy babies and increasing the risk to mothers. Gaining too much endangers both mother and baby, raising the risk of PREMATURE birth, gestational diabetes, preeclampsia and the necessity for Cesarean section. Significant underweight may result in a baby much smaller than it should be, and many such babies never catch up later. Most American clinicians now advise a total weight gain of 28 to 35 pounds if the woman is pregnant with a single fetus and with normal weight at conception, adding a pound a week dur- ing the second and third trimesters. Women who are overweight at conception are advised to limit weight gain to 15 to 25 pounds, gaining only two- thirds of a pound each week after the third month. However, even an obese woman should not gain fewer than 15 pounds in all. For women carrying multiple fetuses, a weight gain of 35 to 45 pounds is recommended. (See also BIRTH WEIGHT; DIET.)
3. in menopause. Ideally a woman should weigh the same at menopause (average age, 50) as her ideal weight at the age of 20. Most women, how- ever, tend to weigh considerably more. By the age of
45 metabolism slows down, and only two-thirds the number of calories to maintain the same weight are required. After menopause another portion of the total calorie intake, which formerly supported an active reproductive system, is no longer needed. In young women body fat ranges from 18 to 23% on the average. With age, the amount of muscle tends to decrease and fat accounts for a greater percentage of weight. By age 60 body fat has gradually increased to about 32% in most women. Further, women tend to become less physically active as they get older. Therefore, unless food intake is reduced accordingly, the unneeded calories will turn into extra body fat. Apart from being unattractive, obesity after menopause greatly increases the risk of developing serious disease, specifically arteriosclerosis and coronary heart disease, hypertension (high blood pressure) and diabetes. The moderately active menopausal woman needs approximately 14 calories per pound of body weight per day to maintain her weight; any calories in excess will most likely be stored as fat. On the other hand, some authorities regard somewhat increased body fat after menopause as normal compensation for diminished estrogen production by the ovaries, since fat cells produce some estrogen.
See also DIET; OBESITY.
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