Weight is a touchy subject for many people, and it can be even more sensitive and complicated if you’re bringing life into this world.
Pregnancy is a time when some women may splurge and finally stop worrying about their weight or those late-night cravings. For other women, it can be full of anxiety as they watch their bodies change and the numbers on the scale rise.
What you can expect: Pregnancy and weight gain
Many moms-to-be ask their health care providers lots of questions, and one of the most popular is how much weight they should gain during their pregnancy.
Unfortunately, that question isn’t so cut and dry. It can depend on a lot of factors. But the best thing you can do is have ongoing conversations with your health care provider to make sure your pregnancy is on track.
During your first trimester (from six weeks to 13 weeks of gestation), you may gain only 1 to 5 pounds—or no weight at all. Most of your weight gain will occur during the second and third trimesters. You may have heard women should gain anywhere from 25 to 35 pounds during their pregnancy, but there’s no one-size-fits-all approach.
“At the first prenatal visit, your OBGYN will determine your body mass index (BMI) and counsel you regarding the benefits of appropriate weight gain, nutrition, exercise, and, especially, the need to limit excessive weight gain to achieve the best pregnancy outcome,” said Colleen Foos, MD, an OBGYN with Banner Health Clinic in Greeley, CO. “For the second and third trimesters, the recommended weight gain will depend on your pre-pregnancy weight and your BMI.”
Factoring your total weight gain
Your BMI, or the standard measure of body fat calculated from your weight and height, helps establish whether you’re underweight, at a normal weight, overweight or obese. This online calculator can help but you should fall within these guidelines published by the Institute of Medicine (IOM):
For a single pregnancy:
- Underweight (BMI less than 18.5): Weight gain should be 28 to 49 pounds
- Normal weight (BMI 18.5 to 24.9): Weight gain should be 25 to 30 pounds
- Overweight (BMI 25 to 29.9): Weight gain should be 15 to 25 pounds
- Obese (BMI more than 30): Weight gain should be 11 to 20 pounds
If you’re carrying twins, you’ll need to gain more weight to support a healthy pregnancy. Weight gain recommendations are:
- Normal weight: Weight gain should be 37 to 54 pounds
- Overweight: Weight gain should be 31 to 50 pounds
- Obese: Weight gain should be 25 to 42 pounds
Steady weight gain is just as important if you’re underweight, overweight or obese, but the amount of weight will be determined by your specific needs.
“For example, if your overweight or obese and you gain less weight than recommended, the baby’s growth will be monitored,” Dr. Foos said. “If the ultrasound shows an appropriately growing fetus, no evidence exists that encouraging increased weight gain to conform to the IOM guidelines will improve mom or baby’s outcomes.”
What happens if you gain too much weight?
Gaining the right amount of weight during pregnancy means gaining just what you need to nourish your growing baby. But what happens if you go a little overboard on the Chick-fil-A shakes and fries? A little treat every once and a while may be fine, but gaining too much weight during pregnancy can increase your risk for many complications, including:
- high blood pressure and preeclampsia
- gestational diabetes
- increased birth weight of the baby (causing increased risk of childhood obesity and obesity in later life)
- increased risk of cesarean delivery (due to larger babies)
- decreased ability for you to lose weight after childbirth
- increased risk of you becoming obese or developing worsening obesity after pregnancy
What happens if you don’t gain enough weight?
Not gaining enough weight can also put you at just as much risk as gaining too much weight. If you don’t gain enough weight during pregnancy, you’re at increased risk for the following:
- decreased birth weight of the baby
- increased risk of fetal growth restriction
“Fetal growth restriction is a more serious condition that could lead to increased risks of prematurity, fetal distress, decreased ability of baby to maintain body temperature, low blood sugar, low blood calcium, impaired immune function, smaller size later in childhood and neurodevelopmental abnormalities,” Dr. Foos said.
Pregnancy is a balancing act
Making sure you’re gaining the right amount of weight can vary woman to woman and pregnancy to pregnancy, but it certainly is a balancing act. Here are some things to keep in mind to keep you and your baby healthy.
Maintain a healthy weight before, during and after pregnancy
One of the best ways to ensure a healthy pregnancy is to be healthy before, during and after you have your baby.
This means if you’re overweight or obese, you should attempt to lose weight before becoming pregnant, due to the increased risk of complications for you and baby. “Overweight and obese women may consider a referral to a weight-reduction specialist for discussion of options, such as behavior modification, weight loss medication or bariatric surgery,” Dr. Foos said.
If you’re underweight, attempt to gain weight to reach a normal weight before becoming pregnant.
[Also read “Can Being Overweight Affect Your Pregnancy?”]
Follow a healthy diet
Make sure you eat plenty of fresh vegetables and fruits, whole grains, dairy and lean meats and proteins. Limit eating foods with added sugars, saturated fats and sodium. “The focus should be on whole, unprocessed foods,” Dr. Foos said.
Exercise
Continue exercising while you’re pregnant—about 20 to 30 minutes of moderate exercise. Talk to your health care provider if you have any questions or concerns.
Don’t skip your prenatal appointments
Nine months can go by quickly, so make sure you keep up with your prenatal appointments. These appointments are meant for your health care provider to track where you are, answer your questions and monitor the health of you and your baby.
If you have concerns about how much weight you should gain during your pregnancy or about being underweight or overweight, contact your health care provider. To find a Banner Health specialist near you, visit bannerhealth.com.
