•To mother -- hypertension and diabetes

•To baby -- premature birth and twice of risk of being overweight later in life.

(Of note: animal studies demonstrate that an obese mother during her pregnancy can predispose her offspring to become susceptible to obesity later in life – and this susceptibility is independent of genes or post birth diet.)

The Times article brings to mind an equally-frightening scenario on the other side of the scale. In Lying in Weight, I wrote about below 90-pound mothers-to-be with anorexia or bulimia. Again there’s a litany of risks.

•To mother: miscarriage, hyperemesis gravidarum

•To baby: birth defects, premature birth, and low birthweight

(Of note: same thing on the animal studies. Pups born to undernourished female rats later developed obesity, hypertension and high insulin levels -- as well as propensity to overeat. The idea is that being starved in the womb teaches embryos to overconserve calories. Later in the life, the offspring balloon out with the smallest intake of food.)

Given all this -- not to mention the costs of all the tests, procedures and equipment to manage pregnancies in women with weight issues -- we might be quick to judge, saying, "My gosh, these women should be anything but pregnant." But I want to move away from the sensationalism and chastisement. I draw upon my experience as a mother with a history of anorexia.

In a woman's passage into adulthood, weight is a metaphor for responsibility. When people say, she is “taking on the weight of the world," they mean that she is assuming the role and responsibilities of an adult.

With pregnancy, a woman stretches her definition of herself. As she reads her “What-to-Expect” books and decorates the nursery, internally she is preparing for the day that she will become a “mom.”

A healthy woman can make the stretch. Literally. Her belly will pop out and so will her new identity. It’s a powerful transition. But it can go awry when a mother is physically challenged by an eating disorder or extreme weight issue. The outcome, of course, depends upon the mother, her willingness to address her problem and the support that she receives along the way.

For this reason, no woman should be the denied the experience of pregnancy, birth and motherhood. It is a transformative one. However, a woman with extreme shape and weight concerns can--and some say should—get help with her problem before pregnancy. With a therapist or a healer as a guide and support, such a woman can better prepare herself to make the transition to motherhood -- with less of a risk to herself and her child.

Isn’t that what we really want? I’m sure the “bariatric obstetricians” would want that too.