How to get rid of weight gained during pregnancy?

Q: I am 25 years old. My weight is 71 kg due to pregnancy though it was 55 kg before pregnancy. I got married last year. I was diagnosed with an endometriotic cyst last year and a laparoscopic surgery for its removal was done. I was also on dufastone for 3-4 months before pregnancy and around 2 months after pregnancy. Doctors advised for early pregnancy and now I have a 2 month old baby boy. However, the gynaecologist who helped me in delivery mentioned that I should not wait for more than 1 year for next pregnancy. She mentioned that my ovaries and intestines were all tangled up and mentioned that its a miracle that the delivery went so smooth and that I was able to conceive so early. I would like to know if I can wait for some time before the next pregnancy or would waiting effect fertility. If it does, what is the time frame you suggest I should wait for? Would it effect my health anyway?

A:At the outset, I would like to remind you that you have gained too much weight, which you conveniently attribute to pregnancy. Let me assure you that pregnancy does not and should not lead to excessive weight gain. Whatever weight you have gained in the last eight months of pregnancy you should lose within a few weeks to six months after delivery. Most women after delivery gain a lot of weight because of this traditional belief that you have to eat high calorie food to produce good milk for the baby. This is indeed a twisted logic. Increasingly, we are seeing obesity as a major health risk following a delivery. Traditionally a lot of raw sugars and fats are fed to a new mother in the first years or so after delivery (all the ghee and panjeeri/laddoos, the special nursing mothers diet). You do not need any of it. You may have been told that milk and ghee is essential for you to produce good quality milk for your baby but this is not medically correct and you should have a healthy balanced diet to produce good milk.If you have noticed cows and buffaloes produce pretty good milk by taking grass (their normal diet). I don't know about you but I have never seen a cow drink milk or ghee! And most I have seen produce pretty good quality milk. I have seen millions of women in this country become fat because of this mistaken belief and ghee in their diet will somehow improve the quality of milk they pass on to their babies. This leads to new obesity and a significant hormonal imbalance with menstrual problems. If you are one of those who have never been overweight but are now, please lose all this maternity weight which is not due to maternity but simple overeating (and eating the wrong kinds of foods).Please increase fruits and vegetables in your diet and cut down on raw fats and sugars. The weight gain is indeed harmful to you and your reproductive health in the long run. Please try to lose this weight as soon as possible. You do not have to starve to lose weight. Nature is on your side. Since all the processes which lead to a weight gain during pregnancy are reversed after delivery, you should be able to lose weight easily. Just take small frequent meals and increase the proportion of fruits and vegetables in your diet. Every time you are hungry in between meals try and take a fruit instead of a fatty snack. Also increase activity as soon as possible. This new weight that you have put on, if it stays, it will probably cause problems in conceiving and childbirth.You have written that your doctor told you that your delivery was a miracle! I have been conducting deliveries for over twenty years now and I believe that not only yours but every delivery is a miracle. Anyway, if with the same uterus and ovaries you have had one normal spontaneous conception and normal delivery, there is no reason why you cannot have many more. As far as the interval between two children is concerned, it is a matter to be decided between you and your husband. We as doctors have no role in this decision. You have written that you have undergone laparoscopic surgery and some hormonal treatment for an Endometriotic cyst. Well, known that you have conceived and delivered so easily we should reasonably assume that there is nothing drastically wrong with your system. Endometriosis is indeed a progressive disorder which may get worse over the years but this may not happen in the near future. Pregnancy actually slows progress of the disease. Waiting for a few years need not be a problem. So whatever time you need for child care should be that time you wait before planning your next pregnancy. If you want to know what would affect your long term health at this stage then losing weight should be your immediate priority. I wish you all the best. Please enjoy motherhood as much as you can at this stage, rather than anticipating how difficult your next conception and delivery would be.