Pregnancy and obesity: what you need to know

Written on April 19, 2023 by Sendra Yang, PharmD, MBA. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• Recommended weight gain in obesity during pregnancy
• Obesity during pregnancy can lead to health conditions
• How to manage weight during pregnancy
• Prenatal care is vital for a healthy pregnancy
• Partner with your healthcare provider
• Related content

Weight gain is a normal part of pregnancy. [1] The specific amount of weight you should gain during pregnancy is dependent on multiple factors, including weight before pregnancy and body mass index (BMI).[1] It’s important that during pregnancy, you don’t lose or gain too much weight for the healthy growth of your baby.[1]

Recommended weight gain in obesity during pregnancy

When your BMI exceeds 30, you are considered obese, putting you at a greater risk of developing chronic health complications. [1,2] A high BMI during pregnancy is associated with increased health risk for you and your baby. [1,2] The recommended weight gain for women and people assigned female at birth who are obese is 11 to 20 lbs (4.95 to 9 kg); for those who are overweight, it is 15 to 25 lbs (6.8 to 11.25 kg).[1] However, according to the Centers for Disease Control and Prevention (CDC), about 48% of pregnancies resulted in weight gain outside of what is recommended.[2] When weight gain exceeds the recommended weight, this can lead to delivery complications requiring medical intervention such as a cesarean section and other health conditions.[2]

Obesity during pregnancy can lead to health conditions

Obesity during pregnancy increases fetal-maternal health risks.[3] Some health risks include macrosomia, stillbirths and premature birth, preeclampsia, or gestational diabetes.[3]

• Macrosomia: Macrosomia is a condition that causes the baby to grow larger than average.[4] A baby that is too large can cause delivery complications and are at higher risk of developing childhood obesity and type 2 diabetes later on in adult life.[5]
• Stillbirths and premature births: A large population study of obesity-related stillbirths shows that people who are overweight or obese are two to four times more likely to have a stillbirth from 40 weeks gestation.[6] Obesity can increase the risk of having premature birth at any gestational stage of pregnancy.[7]
• Preeclampsia: Preeclampsia is a condition that can cause high blood pressure and liver or kidney damage after the 20th week of pregnancy.[8] Risk factors for preeclampsia include obesity and type 2 diabetes.[8]
• Gestational diabetes: Gestational diabetes is a type of diabetes seen during pregnancy for those who previously did not have the condition before becoming pregnant.[9,10]

Further discussion on gestational diabetes

According to the CDC, gestational diabetes affects about 2%-10% of pregnancies in the United States.[9] Hormonal changes during pregnancy are associated with gestational diabetes.[11] This hormone change affects how insulin works in the body to manage sugar levels. High glucose levels in the blood can lead to diabetes.[11] Those who are obese are at a higher risk of developing gestational diabetes than others with a normal BMI.[12] Our current understanding of how gestational diabetes affects people who are obese is thought to be associated with adipose tissue dysfunction.[13] The adipose tissues are fatty storage tissues in the body. When the body accumulates excess fat, it can impair the normal function of insulin.[13,14]

How to manage weight during pregnancy

If you are planning for a family or are pregnant and concerned about your weight, you should first consult with your healthcare provider to determine what you can do to prevent or manage obesity during pregnancy. Weight loss before getting pregnant helps reduce risks associated with pregnancy and obesity.[3] Two ways to help you manage your weight during pregnancy are:

Eating a healthy diet

People who incorporated a healthy diet managed weight gain better and had fewer adverse pregnancy outcomes.[3,15] Eating healthy can reduce the risk of developing gestational diabetes, early birth, or a low-birth baby.[3,15,16] Consult with your healthcare provider or dietitian to help you design a healthy diet. People who are obese that received nutrition counseling had better pregnancy outcomes.[17] Your healthcare provider can recommend healthy food choices, teach you how to portion your meals, and help with meal planning ideas.

Exercising

Exercise during pregnancy can lower the chances of developing gestational diabetes, insulin use, and excessive weight gain.[18] Exercise also helps regulate blood sugar levels.[19] Exercise during pregnancy is safe for most, but consult your healthcare provider to determine what type of exercise and physical activity is appropriate for you. The CDC advises that those who are pregnant or postpartum should do at least 150 minutes of aerobic physical activity per week, such as walking.[19]

Prenatal care is vital for a healthy pregnancy

Prenatal care is essential for a healthy pregnancy, regardless of if you are obese or not. During your prenatal visit, your healthcare provider will perform a physical exam, check your weight, conduct an ultrasound examination of the baby, or do blood tests.[16] Obesity increases the risk of miscarriage, gestational diabetes, and complications during delivery.[3] For these reasons, prenatal care is vital for a healthy parent and baby.[20,21] These tests can help your healthcare provider spot potential health issues affecting you or your baby. Prenatal care improves your chance of a healthy pregnancy and lets you discuss with your healthcare provider about any concerns or questions you may have.[20,21]

Partner with your healthcare provider

Pregnancy can be an exciting time in a woman’s life, but it can come with health risks for both parent and baby, especially if you are obese. It is essential to manage your weight during pregnancy by including healthy habits such as a nutritious diet and regular exercise. Taking preventative measures, being proactive, and consulting with a healthcare provider about your health before and during pregnancy can help support a safe and healthy pregnancy.

Everlywell provides access to a telehealth option where you can consult virtually via a weight loss online appointment with a certified clinician. You can partner with a healthcare professional to develop a care plan for your weight loss goal.

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References

1. Weight gain during pregnancy. Centers for Disease Control and Prevention. URL. Published June 13, 2022. Accessed April 20, 2023.
2. Deputy NP, Dub B, Sharma AJ. Prevalence and trends in prepregnancy normal weight — 48 states, New York City, and District of Columbia, 2011–2015. MMWR Morb Mortal Wkly Rep. 2018;66:1402–1407. doi:10.15585/mmwr.mm665152a3. URL.
3. Riley L, Wertz M, McDowell I. Obesity in pregnancy: risks and management. American Family Physician. URL. Published May 1, 2018. Accessed April 20, 2023.
4. Obesity and pregnancy. American College of Obstetricians and Gynecologists. URL. Accessed April 20, 2023.
5. Sheiner E. Gestational diabetes mellitus: long-term consequences for the mother and child grand challenge: how to move on towards secondary prevention? Frontiers. URL. Published October 12, 2020. Accessed April 20, 2023.
6. Akselsson A, Rossen J, Storck-Lindholm E, Rådestad I. Prolonged pregnancy and stillbirth among women with overweight or obesity—a population-based study in Sweden including 64,632 women. BMC Pregnancy Childbirth. 2023;23(1):21. doi:10.1186/s12884-022-05340-4. URL.
7. Cnattingius S, Villamor E, Johansson S, et al. Maternal obesity and risk of preterm delivery. JAMA. 2013;309(22):2362-2370. doi:10.1001/jama.2013.6295. URL.
8. Preeclampsia: Medlineplus medical encyclopedia. MedlinePlus. URL. Accessed April 20, 2023.
9. Gestational diabetes. Centers for Disease Control and Prevention. URL. Published December 30, 2022. Accessed April 20, 2023.
10. Centers for Disease Control and Prevention. Pregnancy complications. URL. Published February 8, 2023. Accessed April 20, 2023.
11. Gestational diabetes: Causes, diagnosis & treatments. Cleveland Clinic. URL. Accessed April 20, 2023.
12. Leddy MA, Power ML, Schulkin J. The impact of maternal obesity on maternal and fetal health. Rev Obstet Gynecol. 2008;1(4):170-178. URL.
13. Hajer GR, van Haeften TW, Visseren FL. Adipose tissue dysfunction in obesity, diabetes, and vascular diseases. Eur Heart J. 2008;29(24):2959-2971. doi:10.1093/eurheartj/ehn387. URL.
14. Unger RH. Minireview: weapons of lean body mass destruction: the role of ectopic lipids in the metabolic syndrome. Endocrinology. 2003;144(12):5159-5165.doi:10.1210/en.2003-0870. URL.
15. Charnley M, Newson L, Weeks A, Abayomi J. Pregnant women living with obesity: a cross-sectional observational study of dietary quality and pregnancy outcomes. Nutrients. 2021;13(5):1652. doi:10.3390/nu13051652. URL.
16. Eating right during pregnancy: Medlineplus medical encyclopedia. MedlinePlus. URL. Accessed April 20, 2023.
17. Amy G. Cantor MD. USPSTF review: Nonmedical interventions for healthy weight and weight gain in pregnancy. JAMA. URL. Published May 25, 2021. Accessed April 20, 2023. https://jamanetwork.com/journals/jama/fullarticle/2780319
18. Sui Z, Dodd JM. Exercise in obese pregnant women: positive impacts and current perceptions. Int J Womens Health. 2013;5:389-398. doi:10.2147/IJWH.S34042. URL.
19. Healthy pregnant or postpartum women. Centers for Disease Control and Prevention. URL. Published June 3, 2022. Accessed April 20, 2023.
20. Office on Women’s Health. Prenatal care. URL. Accessed April 20, 2023.
21. What is prenatal care and why is it important? Eunice Kennedy Shriver National Institute of Child Health and Human Development. URL. Accessed April 20, 2023.