So, apparently the UK'S National Health Service has decided to try drug treatment to prevent obese babies (what?). And they're doing it by giving pregnant fatties between 500 and 2500mg of metformin per day from 12 weeks gestation to delivery. Because VFHT. Because OMGDEATHFATZ is a worse fate than the drug's increased risk for hypo/hyperglycemia, diabetic ketoacidosis, lactic acidosis and unspecified cardiovascular risk, not to mention a host of other unpleasant side effects. Like smelling like a fish. Oh, and the completely unknown risks to the developing fetus: "There are no controlled data in human pregnancy. [...] Metformin is only recommended for use during pregnancy when benefit outweighs risk." No breastfeeding when the baby is born, either.
Somehow, I'm seeing a problem with the idea of giving pregnant women of any body type this kind of drug, unless she actually has diabetes.
What does metformin actually do, though? Well, it reduces the liver's sugar production and decreases the amount of sugar absorbed into the body. It also increases the sensitivity of the body's insulin receptors, which means what little sugar is left in the bloodstream is more quickly absorbed. Assuming this doesn't lead to hypoglycemia, the body will adapt to this by reducing insulin production.
This is all on the unfounded hypothesis that obese mothers transfer greater amounts of sugar to their fetus, which results in fatter babies. Reduce the sugar in Mom's bloodstream, reduce sugar to the baby, reduce baby size. We have officially moved into the realm of unsightly fat on infants, completely uncognizant of the health benefits of baby chubbiness. Is it just me, or does this actually sound like Baby's First Diet? The Pre-Natal Weight Loss System! Because reducing sugar intake totally makes adults lose weight long-term, right? It should totally work for a fetus, too!
The BBC article on the subject is, of course, full of anti-fat themes, not the least of which is the conflation of fat and health, but the most egregious part of the article is the inclusion of "expert advice" from Dr. Ian Campbell of the British charity (lolsob) Weight Concern. In his words, "In an ideal world you would want women to take stock of their weight before pregnancy, but in reality that's not going to happen."
He is literally saying that fat women should not procreate, and by extension, those that do are irresponsible. Nevermind that there is no solid scientific evidence that supports the idea that fat is unhealthy. Nevermind that the weight cycling that he is encouraging is far more damaging to health than simply having a stable BMI of 30 could ever be. Nevermind that the fat stigma that he is perpetuating encourages the weight cycling mentioned above, as well as depression, eating disorders, obsession with food and weight, low self-esteem and body dysmorphia - not to mention that it demotivates the pursuit of health.
How about we, y'know, start focusing on health, not weight?
Because that would be great.