Women's Section: Hormones, Emotions, and the Prevention of Postpartum Obesity

**Women's Section**

Mona Lisa has also gained weight.

This is a very famous painting by Leonardo da Vinci from 500 years ago. The artist often used this painting to ask many friends, including students, colleagues, the general public, and patients, to estimate Mona Lisa's height and weight. Their answers were all based on their current understanding of the figure, meaning they all overestimated the height and underestimated the weight of the person painted by da Vinci.

In fact, Mona Lisa was rather plump and full-figured, as she was of Italian descent. 500 years ago, nutrition was not widespread, and people were generally shorter, as evidenced by the low bed frames seen in European castles. Mona Lisa was actually less than 150 centimeters tall and weighed over 60 kilograms. If she lived in modern times, she might be even fatter and more obese due to consuming too much modern food, much like the 80-kilogram village women commonly seen in Italy today.

Actually, we are discussing a very serious topic in a lighthearted manner because obesity has affected the very lifeline of the entire country. After 200 years of industrialization, southern Italy's industrial development has reached a bottleneck. People have gradually come to live a life where material goods are cheap and readily available. Although their savings may not be large, they drink nearly a kilogram of wine every day and eat too much meat, cheese, and bread, resulting in excessive calorie intake and extreme obesity.

Women are made of hormones

Many women experience unusual eating habits during pregnancy, known as pica; they also tend to crave sugary foods during their menstrual cycle, known as premenstrual gorger. Calorie intake is difficult to control before menstruation, potentially increasing by 20-30% compared to normal. Furthermore, due to the water retention effect of various hormones, water retention and weight gain are normal physiological phenomena before menstruation.

Therefore, women trying to lose weight should not judge based on a single day, but rather look at the overall trend of the curve, comparing the beginning of this cycle with the beginning of the previous cycle, and the end with the end, in order to obtain an objective result. That's why some people say that women are made of hormones, with rhythmic changes in cycles.

I have a female college student with bulimia. The most difficult time for her to treat in the past five years has been before her menstrual period; she needs to use psychiatric medications covered by national health insurance to see any effect.

You can gain weight if you're in a bad mood.

The command center for our eating is the hypothalamus, but the cerebral cortex also "connects" to the hypothalamus to "guide" human eating behavior. In particular, the large intestine cortex of the frontal lobe is the place where human spirit and will are governed. When life is stressful, lonely, anxious, or encountering setbacks, people tend to increase the frequency and amount of eating.

In addition, people who often have excessively strong emotions and are frequently unaware of what is troubling them are more likely to experience binge eating. Binge eating refers to eating excessively until one feels uncomfortable in the stomach, or eating excessively until one feels nauseous, or swallowing large amounts of food alone without chewing slowly, or eating until someone else appears.

These phenomena are widely observed in Western societies, with some areas experiencing them in as many as a quarter of women. Of course, binge eating disorder can also occur in men, though at a lower rate. When women suffer from binge eating, they often crave sweets. After digestion and absorption, sweets enter the brain, increasing the concentration of serotonin, which can improve mood. Therefore, a bad mood often leads to weight gain.

Prevention of obesity in women

Women are prone to obesity after childbirth. 85% of the author's patients are women, and statistics show that 44.8% of them experience postpartum obesity. Why is this? It's all about postpartum recovery! The author has many reflections on "replenishment," which stems from the Chinese lifestyle and dietary habits.

In the past, young wives had to wait until their fathers-in-law, mothers-in-law, husbands, and children had all eaten before they could eat the leftovers. As a result, many young wives in those times suffered from malnutrition, especially deficiencies in calcium, iron, and protein. Therefore, far-sighted ancient sages advocated that women should "nourish" themselves before and after childbirth. At that time, "nourishment" was in line with the trend of the times and also met the needs of medicine and nutrition.

But things are different now. People can eat whatever they want, and it's easy for everyone to reach the energy levels recommended by the Department of Health each day. So unless people are unaware of the risks or have incorrect eating habits, malnutrition is not a common problem. The problem is that the concept of "supplementation" is still deeply ingrained in people's minds.

But how many nutrients are needed during pregnancy? No additional calories are needed in the first three months. Only in the second and third months is an increase of 200 calories required, and only in the third and third months is an increase of 400 calories required. For modern women who are not breastfeeding, their postpartum diet should be the same as that of a healthy person.

However, modern women often consume excessive calories, protein, and fat during pregnancy, while lacking sufficient vitamins, iron, and calcium. They may have too much of what they should have and too little of what they shouldn't. As a result, modern women frequently gain twice the expected weight during pregnancy and childbirth. Therefore, it is clear that dietary concepts before and after childbirth in Taiwan urgently need to be strengthened.

Women often experience a poor appetite and changes in taste during the first three months of pregnancy, but their appetite usually improves in the following six months. Weight gain is also closely related to societal attitudes and beliefs, so pregnant women should consult a doctor.

When the author provides consultations at the weight loss clinic, he always uses an objective approach, including assessing the woman's nutritional quality index, essential nutrients, dietary recommendations from the Department of Health, and the client's daily food intake. Based on the individual case, he then guides the patient on what foods are unsuitable and what foods are lacking, and provides supplementation based on the deficiency, such as calcium, iron, and vitamins. The amount is neither too much nor too little, and is entirely determined by the individual's situation.