Most women lose weight gradually after giving birth, and a slow pace is normal. MedlinePlus advises waiting until the postpartum check-up before trying to lose weight and, when breastfeeding, until the baby is around two months old and milk supply has settled. When weight does not change despite a consistent plan, we recommend checking thyroid function and blood sugar. Postpartum thyroiditis is treatable, and where clinically indicated your endocrinologist may also consider insulin resistance or polycystic ovary syndrome.
- A gradual pace over the first year after birth is normal, and MedlinePlus advises waiting until the postpartum check-up before starting to lose weight.
- A Cochrane review of 12 trials involving 910 women found that diet, or diet combined with exercise, helped women lose more weight after childbirth than usual care.
- Most adults are advised to aim for around seven to nine hours of sleep a night, and short sleep can raise ghrelin and cortisol and lower leptin.
- The American Thyroid Association states that postpartum thyroiditis affects around 5 to 10% of women and can cause weight gain in its underactive phase.
- The US Centers for Disease Control and Prevention states that around half of women with gestational diabetes go on to develop type 2 diabetes, which is a reason to have blood sugar checked.
- Weight loss medication is not used during pregnancy and is not recommended while breastfeeding, and your endocrinologist will discuss the timing with you.
Many women are told to be patient about weight after pregnancy, and for most women a gradual pace is normal. For some, a thyroid, blood sugar or hormonal condition makes weight harder to lose, and a blood test can identify it.
What does a realistic postpartum timeline look like?
MedlinePlus, published by the US National Library of Medicine, advises waiting until the postpartum check-up, around six weeks after birth, before trying to lose weight. For women who are breastfeeding, it advises waiting until the baby is at least two months old and milk supply has settled before reducing calories, and it notes that losing weight too quickly can reduce milk production.
Most women lose weight gradually over the following months, and the pace varies widely. A slower pace is not a sign that something is wrong. The US Centers for Disease Control and Prevention states that people who lose weight at a gradual, steady pace of around 0.5 kg to 1 kg a week are more likely to keep it off than people who lose it faster.
A Cochrane review of 12 trials involving 910 women found that diet alone, or diet combined with exercise, helped women lose more weight after childbirth than usual care. Exercise alone did not make a significant difference, and the programmes in the review did not appear to affect breastfeeding.
Why is it harder to lose weight after a baby?
Sleep
Most adults are advised to aim for around seven to nine hours of sleep a night. Short sleep can raise ghrelin, the hormone that increases appetite, and cortisol, while lowering leptin, the hormone that signals fullness. Broken sleep is common for new parents in the first year, and it can make appetite harder to manage.
Time and routine
Regular meals and time for activity are harder to maintain with a young baby, and meals are often skipped. A plan built around simple meals with protein and short periods of activity can be easier to sustain in the first year.
Hormonal changes
Hormone levels change substantially after birth and again when breastfeeding stops. For most women these changes settle without treatment. For some, a hormonal or metabolic condition develops or becomes apparent in the months after birth.
When is weight that will not move a thyroid question?
Postpartum thyroiditis
Postpartum thyroiditis is inflammation of the thyroid gland after childbirth. The American Thyroid Association states that it affects around 5 to 10% of women and is thought to be an autoimmune condition. Postpartum thyroiditis can begin with an overactive thyroid, causing symptoms such as palpitations, anxiety and weight loss. Some women later develop an underactive thyroid, which may cause fatigue, constipation, low mood and weight gain. The overactive phase typically begins one to four months after delivery and the underactive phase around four to eight months after delivery.
Most women regain normal thyroid function within 12 to 18 months, and the American Thyroid Association states that around 20% of women who enter the underactive phase remain hypothyroid. Positive thyroid antibodies, a previous episode after an earlier pregnancy, previous thyroid problems and a family history increase the risk. The symptoms overlap with ordinary tiredness after a baby, so the condition can be missed. Weight gain around six months after birth is a reasonable prompt for a thyroid blood test.
How do blood sugar, insulin resistance and gestational diabetes fit in?
Gestational diabetes is diabetes that develops during pregnancy. It generally resolves after birth, although it remains a marker of later risk. The US Centers for Disease Control and Prevention states that around half of women with gestational diabetes go on to develop type 2 diabetes, and it advises asking your doctor how often to have your blood sugar checked.
Insulin resistance can also make weight loss more challenging and is often associated with increased waist circumference. It is not a standalone diagnosis, and your endocrinologist will consider it where it is clinically indicated, for example after gestational diabetes or where weight has settled around the abdomen since birth. In that case, blood sugar and insulin tests may be useful, and our page on prediabetes explains what the results can mean.
Can PCOS affect weight after pregnancy?
Polycystic ovary syndrome (PCOS) affects around one in ten women of reproductive age and can influence weight and metabolism. It is not a new diagnosis that follows pregnancy by default. Your endocrinologist may consider it where it is clinically indicated, for example where irregular cycles return or weight does not respond as expected. Insulin resistance is common in PCOS. PCOS is treatable, and identifying it does not delay treatment; it helps your endocrinologist tailor the treatment plan to address the underlying issue as well as your weight.
Why can weight rise after stopping breastfeeding?
Breastfeeding uses energy. MedlinePlus states that women who are breastfeeding need around 500 extra calories a day. When breastfeeding stops, that additional energy use stops too. Appetite and eating habits may not change at the same time, and weight can rise as a result.
Hormonal changes after weaning can also affect appetite and cycles for a period. If weight continues to rise once breastfeeding has stopped and eating habits have been adjusted, we recommend checking thyroid function and blood sugar.
Is weight loss medication appropriate after pregnancy?
Weight loss medication is not used during pregnancy because it may harm an unborn baby, and it is not recommended while breastfeeding. Our endocrinologists do not prescribe it during either period.
After breastfeeding has finished, the decision follows the same assessment as for any other patient. Our endocrinologists prescribe weight loss medication for patients with a body mass index above 30, or above 27 where there is a weight-related condition such as type 2 diabetes, hypertension or high cholesterol. Your endocrinologist will also discuss contraception and any plans for a future pregnancy. The medication needs to be stopped before trying to conceive, and the prescribing information for each medication sets out how long before. Patients should not decide by themselves to start a GLP-1 medication. A doctor’s review is critical to ensure the treatment is safe and appropriate for the individual.
What does Endocare check?
Your first appointment is a full medical assessment. Your endocrinologist will take a full medical history, including your pregnancy and any gestational diabetes, review your thyroid function, blood sugar and other blood tests, and examine you before discussing a plan. At Endocare, body composition analysis is included free of charge at every consultation. Body composition analysis estimates body fat, muscle mass and body water. Repeated measurements help your endocrinologist understand how your body is changing beyond the number on the scale.
The UAE National Health Survey 2017 to 2018, published by the Ministry of Health and Prevention, found obesity in 30.6% of women aged 18 to 69. Our page on weight loss after 40 for women covers a later life stage with similar questions. Monthly follow-up appointments can be held in person at the clinic or online. We recommend the first consultation in person, as it includes a physical examination and body composition analysis.
Frequently asked questions
How long does it take to lose weight after pregnancy?
It varies, and a gradual pace over the first year is normal. MedlinePlus advises waiting until the postpartum check-up, around six weeks after birth, before trying to lose weight, and longer when breastfeeding, until the baby is at least two months old and milk supply has settled.
Why is it harder to lose weight after a baby?
Broken sleep, limited time for meals and activity, and hormonal changes all play a part. Short sleep can raise appetite hormones, and for some women a thyroid or blood sugar condition develops or becomes apparent in the months after birth.
Could my thyroid be the reason?
Postpartum thyroiditis can contribute. The American Thyroid Association states that it affects around 5 to 10% of women, and its underactive phase, typically four to eight months after delivery, can cause weight gain and fatigue. A thyroid blood test can identify it.
Why did I gain weight after stopping breastfeeding?
Breastfeeding uses energy, which MedlinePlus puts at around 500 extra calories a day. When it stops, energy needs fall while appetite and eating habits may not change at the same time. If weight keeps rising after you have adjusted your eating, we recommend checking thyroid function and blood sugar.
Can I take weight loss injections while breastfeeding?
Weight loss medication is not recommended while breastfeeding, and it is not used during pregnancy. Once breastfeeding has finished, your endocrinologist can assess whether it is appropriate for you.
When should I see a doctor about this?
We recommend a consultation if your weight has not changed by around six months after birth despite a consistent plan. A consultation is also worthwhile if you have symptoms such as marked fatigue, palpitations or low mood, or if you had gestational diabetes and have not had your blood sugar checked since the birth.
If your weight has not moved after pregnancy despite a consistent plan, a consultation can check the medical reasons first. Your endocrinologist will review your thyroid function, your blood sugar and your body composition analysis, and will set a plan that fits your life with a young child.
You can speak to an endocrinologist at our clinics in Dubai and Abu Dhabi.
