But thanks to a new program called Choose Health LA Moms launched in November of 2015, mothers in LA County now have access to a free tool that can dramatically help them lose weight in the months after giving birth.

According to the program’s founder and current director, Diana Ramos, MD, MPH, Director Reproductive Health, Los Angeles County of Los Angeles Public Health, there are very few programs out there that have specifically addressed weight loss for new moms. “Most OB/GYNs find ourselves telling new moms that they need to start losing weight,” explains Dr. Ramos, “but there are so many other details being covered in the postpartum visit, that we aren’t giving them instructions on how to lose weight – especially at a time when they are going to be busy caring for a newborn.”

Given a choice between catching up on sleep or going to the gym – if that’s even a choice for some – you can bet that most new moms will choose the former.

Based on that simple premise, the Choose Health LA Moms program focuses on three things that new moms do already: walk, drink water and breastfeed.

For example, motivational messages encourage mothers to drink water before they eat and to replace sugary drinks with water; and to get up and move around the house or walk around the block. Recommendations are aligned with national initiatives such as Michelle Obama’s Let’s Move and Drink Up campaigns, and are accessible to all women. Under the Affordable Care Act, for instance, breastfeeding supplies and counseling are available without a copay to those with health insurance.

The self-modulated program also delivers information in the ways that moms are already using to communicate. New moms are some of the highest users of text messages, and they also have high usage rates on social media and other information sharing platforms where they go to exchange experiences and pictures.

The six month program is available in English and Spanish and is free to LA County moms, who can enroll when they are still in the hospital. Once signed up, weekly text and email messages reinforce the three activities for losing weight (though moms can opt-out of an activity if she chooses), with a link to a lesson online that highlights issues relevant to each week after having a baby. Moms can track their progress on the web site and earn badges for participating throughout the duration of the program.

A pilot program that preceded the launch earlier in 2015 was highly successful. Twelve weeks into the six month pilot, an astounding 96% of the 50 women participating lost all of the weight that they had gained during pregnancy – and 46% went on past their pre-pregnancy weight to lose even more – just through the simple acts of walking, drinking water, and breastfeeding.

Compare this result to the average woman, who without making any effort to lose weight retains 12 pounds every time she has a baby. For the 38% of women who do get back to their pre-pregnancy weight, it takes two years.

Much thought and development have been put into the program, which was three years in the making. For example, the program takes into consideration whether the mom had a vaginal or C-section delivery. Messages are also specific to where she is in the post-partum timeline. For example, messages for the first week after having a baby will address issues that are pertinent and common at that time, such as questions about breastfeeding, to which the program will highlight solutions that the mom can try.

This approach proved highly successful in the pilot. In fact, three moms who had been bottle-feeding exclusively switched to breastfeeding – a workout in itself that can burn up to 500 calories. Another result was that one out of two mothers continued to breastfeed after three months, exceeding LA County rates. All of the moms drank more water, and 94% were walking more.

Social determinants of health

An important component of the program – one that is crucial to its initial success – is that it addresses the social determinants of health; that is, the environment in which the patient lives. “Traditionally, healthcare providers didn’t think much about the patient’s life beyond the office visit walls,” says Dr. Ramos. “But where they live, their access to healthy food, if they suffer depression, if there’s violence in the family and they don’t feel safe – all of these are social determinants of health that can impact the health and well-being of the patient and their ability to follow through with recommended treatment plans and activities.”

Many times, social determinants of health lead to the unhealthy habits that cause weight gain in patients, and the inability of new moms to lose weight after childbirth. The Choose Health LA Moms program takes this into account with a baseline questionnaire that looks for signs of depression and other social determinants of health, and then points these moms to additional resources provided by LA County, dealing with everything from mental issues and family violence to information on contraception so they can plan their next pregnancy.

It seems like the educational campaign to help moms lose weight is paying off in more ways than one. Results show that moms are not just walking more by themselves, they are walking with their kids and other family members, and everybody in the family is drinking more water.

“We know that obesity can lead to negative health consequences for the mom, but it can also affect the child because mom is their first role model,” concludes Dr. Ramos. “If we can help the mom get to a healthy weight and maintain healthy habits, the hope is that her child, and in fact the whole family, will be inspired to follow along.”

The LA County-wide program is now in the process of accepting new moms, who can join Choose Health LA Moms for free at: https://www.choosehealthlamoms.com/