Prenatal wellness
Excessive Weight Gain in Pregnancy
Gaining more weight than recommended during pregnancy can increase risks for you and your baby. Learn how to identify excessive gain, why it matters, and the steps you can take with your healthcare team.
How to Use This Guide
Use this resource alongside weight-tracking tools and regular prenatal visits:
- Compare your weight trajectory with Institute of Medicine (IOM) guidelines for your pre-pregnancy BMI.
- Discuss trends with your obstetric provider—especially rapid gains or losses between appointments.
- Adopt tailored nutrition, activity, and behavioral strategies to stay in the recommended range.
Formula
Weekly gain (2nd/3rd trimester) = Total current gain − First trimester gain ÷ (Gestational weeks − 13)
Compare to recommended weekly gain (based on BMI category):
- Underweight: 0.45–0.6 kg/week
- Normal weight: 0.4–0.5 kg/week
- Overweight: 0.2–0.3 kg/week
- Obese: ~0.2 kg/week
Calculate cumulative targets with Total recommended gain = BMI-specific range (IOM 2009). Use our BMI-weight-gain calculator for personalized values.
Full Description
Excessive gestational weight gain is associated with gestational diabetes, hypertensive disorders, cesarean delivery, macrosomia, and postpartum weight retention. Babies born to mothers with high weight gain are more likely to experience childhood obesity and metabolic disorders.
Factors contributing to rapid gain include high caloric intake from ultra-processed foods, sedentary lifestyle, fluid retention, corticosteroid therapy, and untreated thyroid disorders. Behavioral contributors—stress eating, sleep deprivation, and lack of support—also play roles.
Interventions focus on balanced nutrition (adequate protein, fiber, and micronutrients), moderate activity (150 minutes/week of prenatal-approved exercise), stress reduction, and ongoing provider guidance. Registered dietitians can tailor meal plans to cultural preferences, cravings, and morning sickness challenges.
Frequently Asked Questions
How can I tell if weight gain is water retention?
Sudden increases (≥1–2 kg in a week) with swelling, especially in hands/face, may indicate fluid retention or preeclampsia. Consult your healthcare provider immediately.
Is dieting safe during pregnancy?
Intentional calorie restriction is generally discouraged. Focus on nutrient-dense foods and portion control under medical supervision.
What if I had bariatric surgery?
Pregnancy after bariatric surgery requires specialized monitoring for nutrient deficiencies and growth parameters. Work closely with your bariatric and obstetric teams.
Can I still breastfeed if I gained too much?
Yes. Breastfeeding can help with postpartum weight loss and offers health benefits for baby and parent. Seek lactation support if needed.