Weight Loss

Weight loss is influenced in part by genetics, and occurs in most cases of HG unless effective medications and nutritional support are offered early in pregnancy. Weight loss may be rapid until the mother becomes emaciated and her metabolism slows. The more weight a mother loses, the greater the risks to her and her child, and the longer her recovery.

Swelling (Edema)

Edema may develop in some patients due to fluid shifts, low protein intake and refeeding syndrome. Monitor weight changes often until patients are asymptomatic and stable.

Weight Loss Calculator

Calculate your Percent Weight Change by entering your usual weight and actual (current) weight below.

NOTE: These scales are based on non-pregnant subjects.
* Percent Weight Change = [(Usual Weight - Actual Weight) ÷ (Usual Weight)] x 100

Is her weight loss severe?

No research has established weight loss amounts that are safe during pregnancy. Our research finds that there is significant risk to the baby’s long-term health when a woman’s weight loss exceeds 15% of her pre-pregnancy weight.

Other factors need consideration such as the pre-pregnancy weight, which if low, puts mother and baby at greater risk by weight loss. Conversely, a mother who is overweight prior to pregnancy may be able to lose a little more weight without significant risk, provided she gets adequate essential nutrients like vitamins B1, folic acid, and vitamin K.

According to ASPEN, for non-pregnant women, severe weight loss is >2% in a week or >5% in a month. Severe malnutrition is less than 50% of you needed dietary intake for over a week. Pregnancy is an accelerated state of starvation so women likely qualify sooner. Many women with HG would easily be considered malnourished and should be screened carefully and given nutritional intervention.

White JV, Guenter P, Jensen G, et al. Consensus statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). JPEN J Parenter Enteral Nutr. 2012;36(3):275–283. FROM-Adult Nutrition Support Core Curriculum, Third Edition, 9. Malnutrition Screening and Assessment

Refeeding Syndrome

Patients at Risk for Refeeding Syndrome

Poor nutritional intake
Weight loss >15%
Prolonged IV hydration
Significant stress
Electrolyte & nutrient depletion

More Information

Genetics and Weight Loss

Given new genetic findings associating GDF15 with HG, as well as research identifying inflammatory markers are often elevated in HG, nutritional risk may be greater still. ASPEN and other experts state a weight loss over 7.5% in 3 months is considered severe malnutrition. Our research finds weight loss exceeding 15% is not uncommon, and women may lose over 25% of their preconception body weight due to HG. Regardless of BMI, these women need nutritional intervention, at a minimum micronutrient repletion.

Monitor: even when weight loss slows

It should not be assumed that slowing of weight loss after several weeks signals improvement. Rapid weight loss early on is partly due to loss of muscle and fat, which will eventually slow down when body mass and activity level drop below normal. Any woman experiencing unintentional weight loss during pregnancy should be assessed and monitored closely until she maintains her weight and her BMI (body mass index) is within normal limits.

Weight Loss and Postpartum Recovery

It should also be remembered that insufficient weight gain in pregnancy can result in a prolonged recovery for the mother. This can also put her at great risk for postpartum depression, debility, and other difficulties. Consideration should be given to nutritional intervention if she is unable to make up for early weight loss by mid-pregnancy, as well as gain enough weight in later pregnancy. Monitoring BMI and net weight change from pre-pregnancy weight throughout pregnancy is important. Women using the HG Care App can share their app Insights Report with this information.