Multidisciplinary Obstetric Medicine Service (MOMS)
Women's Medicine Collaborative

Excess Weight and Weight Gain During Pregnancy

The amount of weight gained during pregnancy is an important factor for the health of your pregnancy and for your and your baby’s long-term health.

The amount of weight you should gain is determined by your body mass index (BMI) before pregnancy. A BMI of 18.5 to 24.9 is classified as normal weight. A BMI of 25 to 29.9 is classified as overweight. A BMI of 30 or greater is classified as obese. Women with a normal weight BMI are recommended to gain 25 to 35 pounds during pregnancy, women with an overweight BMI should gain 15 to 25 pounds, and women with a BMI of 30 or greater should gain 11 to 20 pounds.

Women who have excess weight before pregnancy have an increased risk of various complications, including gestational diabetes; high blood pressure disorders, such as preeclampsia; sleep apnea; and the need for a C-section. They are also more likely to have children who become overweight or obese.

Gaining too much weight during pregnancy can increase the risk of health problems in your baby, such as being born significantly larger than average, and can cause complications at birth, such as shoulder dystocia or preterm birth. Excessive weight gain during pregnancy can also increase the likelihood of postpartum weight retention.

Your doctor will help you determine how much you should gain and help manage your weight throughout pregnancy.

How Often Does Pregnancy Weight Gain Happen?

One in five women in the U.S. have a BMI of 30 or more at the start of pregnancy. Around 1 in 5 women gain more than 40 pounds during pregnancy, which is more than any woman should gain. Only about one-third of women gain the recommended amount of weight during pregnancy.

What Are Some Symptoms of Pregnancy Weight Gain?

Excess weight can cause some day-to-day health issues, including breathlessness, snoring or sleep apnea, heartburn, increased sweating, fatigue, and joint and back pain. Obesity can lead to high blood pressure, high blood sugar and high cholesterol levels, which can also affect your pregnancy.

What Are Some Causes of Pregnancy Weight Gain?

The most common factors that contribute to increased weight are excess food intake and a lack of physical activity. Some medications, such as certain antidepressants or anticonvulsants, and some diseases, such as hypothyroidism or polycystic ovary syndrome, can contribute to obesity.

How Can Excess Pregnancy Weight Gain Be Treated?

Losing weight prior to your pregnancy is the best way to decrease the risk. Even losing 10 to 20 pounds can improve your overall health and start you on the way to a healthier pregnancy.

Although there are risks, you can still have a healthy pregnancy if you have excess weight. You will need regular prenatal care to monitor your pregnancy for complications and prepare for special considerations for your labor and delivery. You will need to eat healthy to provide good nourishment to both your baby and your own body.

Eat a Healthy Diet

There are some healthy habits you can start at home to lose weight before becoming pregnant or to help manage your weight while pregnant.

Changing what, how often, and how much you eat can help keep your weight in a healthy range. Ask to speak with a registered dietitian to determine an individualized healthy eating plan. In general, the first trimester of pregnancy does not require any extra calories. Women need around 340 additional calories per day during the second trimester and around 450 additional calories per day during the third trimester.

Get Regular Exercise

Regular, moderate exercise during pregnancy helps control your weight. Aim for at least two and a half hours per week of moderate exercise, or 30 minutes a day, 5 days a week. If pregnant, talk with your doctor before you start exercising to determine the best workouts for you that won’t place too much stress on your lower body. To lose weight before pregnancy, aim for 150 minutes a week of moderate to vigorous exercise.

Know What’s Off Limits

Avoid alcohol, cigarettes, and any illicit drugs.

When Should I See My Doctor for Pregnancy Weight Gain?

Your weight and the growth of your baby should be tracked at each prenatal visit. If you are gaining less than the recommended guidelines, but your baby is growing well, you do not have to increase your weight gain. If your baby is not growing well, your doctor may make changes to your diet and exercise plan.

Call your doctor if you have any symptoms such as:

  • Headaches
  • Dizziness
  • Shortness of breath
  • Loud snoring (a sign of possible sleep apnea)
  • Rapid heartbeat

Learn more about Multidisciplinary Obstetric Medicine Service (MOMS) at Lifespan