Becoming pregnant is one of the most magical times and experiences to go through. But for moms who begin their pregnancies with a little extra weight, it can instead be stressful, confusing, and challenging. After all, being overweight and pregnant has serious health risks.
The good news? It’s very possible to make the best of the situation, cut down on both your and your baby’s risks of health problems, and have a healthier pregnancy and delivery – all without starving yourself to death or having to resort to anything crazy.
Here’s everything you need to know about the risks of being pregnant and overweight, how to lose weight while pregnant, and what’s safe (and what’s not) when it comes to dropping pounds before giving birth.
All Pregnant Women Should Gain Weight
First things first, it should be made clear that unless otherwise specified by a doctor, all pregnant women should gain weight during their pregnancies and not actively seek to drop pounds.
Yes, this means that even if you happen to be obese going into a pregnancy, you still need to gain weight regardless. How much weight you have to put on, though, is what differs.
Obese Women: Need to put on between 11 and 20 pounds (5 and 9 kg) during pregnancy.
Overweight Women: Need to put on between 15 and 25 pounds (7 and 11 kg) during pregnancy.
Normal Weight Women: Need to put on between 25 and 35 pounds (11 and 16 kg) during pregnancy.
Underweight Women: Need to put on between 28 and 40 pounds (13 and 18 kg) during pregnancy.
Keep in mind that these ranges assume you’re only pregnant with one child. If you’re pregnant with twin babies or multiples, talk to your doctor about how much weight you need to put on for a healthy pregnancy.
How Much Extra Calories A Day Does That Mean?
For normal-weight women going into a pregnancy, that means an excess of 300 calories consumed a day is needed.
However, this may vary a lot from one woman to another, so ask your doctor for their take on how much excess calories you need to be consuming on a daily basis.
Risks to Pregnant Women Who Are Overweight
Although pregnancy presents potential dangers of its own – coupled with being overweight or obese, there’s a whole world of other risks involved.
While you may be in ideal health apart from a few extra pounds you have on you, the medical dangers are real for both you and your baby.
What is Considered “Overweight” or “Obese”?
While your obstetrician or midwife may have their own guidelines for what constitutes obesity, in general, practitioners look to your body mass index (BMI) for specifics.
If your BMI falls between 18.5 and 24.9, your weight is considered to be “normal.” A BMI between 25 and 29.9 is defined as “overweight,” and a BMI over 30 indicates obesity.
BMI calculations only use your height and weight, however, which means the figure is somewhat limited overall.
How Does Extra Weight Affect Pregnancy?
Moms-to-be who are carrying extra weight while pregnant may have difficulty moving around and might feel more tired than other moms-to-be of average weight.
Also, obesity can create a whole host of other pregnancy-related complications such as:
- Risk of miscarriage, stillbirth, and recurrent miscarriage
- Gestational diabetes
- Preeclampsia (high blood pressure, kidney damage)
- Cardiac dysfunction
- Blood clots
- Sleep apnea
- Difficult vaginal delivery
- The need for a C-section, along with C-section complications
- Pre-term birth
- Birth defects (such as spina bifida)
If you’re obese, your baby also has a higher chance of being larger than average and having more body fat than normal when born.
Babies with moms who are obese are also more likely to have congenital disabilities, though the diagnosis of such issues via ultrasound can be difficult because of mom’s plus size.
Of course, it’s still possible to have a healthy pregnancy regardless of your body type or size, though your journey may need to involve weight loss to some degree – or at least doing some damage control and not putting on too much excess weight until you give birth.
Tips for Avoiding Putting on Extra Weight While Pregnant
If you’re already overweight, there’s always a chance that your doctor or midwife might deem it too dangerous for you to lose weight after conceiving.
However, there are still steps you can take to avoid gaining too many pounds. In other words: damage control.
Although every mom (and baby) is unique, there are guidelines on how much weight women should gain throughout their pregnancy.
For a single pregnancy, moms who are obese should aim to add fewer than 20 pounds. Moms who are carrying multiples should gain between 25 and 42 pounds.
To keep within those guidelines, try a few of the following:
- Swap out unhealthy snacks for lower-calorie and nutrient-dense options
- Drink more water each day, and cut out sugary beverages if you typically drink them
- Take a walk daily—walking can also help your body prepare for labor!
- Have a small salad before each meal to avoid filling up on less nutritious and “heavy” foods
With a few simple swaps and steps, you can cut down how much weight you gain during pregnancy, performing damage control and potentially helping both you and your baby to be healthier.
How to Lose Weight Safely During Pregnancy
Not every woman should aim to lose weight during pregnancy, especially if your doctor hasn’t specifically stated that it’s safe for you to do so, and there are many variables to consider for every mom-to-be.
If your health care provider suggests you lose weight during pregnancy after you two had a discussion about this, there are safe ways to do so.
Keep the following in mind at all times.
1) Don’t Go on a “Diet”
There are tons of diet programs to choose from, from tracking points to counting carbs.However, there are no programs proven safe for pregnant women.
And if you ask most obstetricians or midwives, they will warn you to stay away from boxed diets and radical weight loss plans.
Although “dieting” can work for the short-term, research suggests diets don’t work long-term for keeping that weight off. So while a crash diet may achieve immediate results, it’s not safe or suitable for long-term weight maintenance.
Instead of “dieting,” start incorporating healthier foods into your regular meals.
Finding new and healthier foods can help you replace junk you previously enjoyed, cementing those better habits into your pregnancy and beyond.
2) Eat Nutritious Food
Although you may want to lose weight fast, counting calories is not appropriate for a healthy pregnancy!
And while your doctor or nutritionist may recommend sticking within a set limit for calorie intake, you should also focus on consuming enough nutrients for you and your growing baby.
A pregnant woman’s daily diet should consist of nutrient-dense meals and snacks, plenty of water, and occasional treats. At the end of the day, it’s all about balance.
A typical pregnancy meal plan should include:
- Five servings of fresh fruits and veggies (including dark green and orange vegetables and a serving of citrus)
- Six servings of whole-grain bread or cereals
- Three servings of nonfat or low-fat milk or milk products
- Two to three servings of extra-lean meats, chicken, fish, or cooked dried beans or peas
- Eight glasses of water
For moms with dairy sensitivities, allergies, or other food preferences, there are plenty of substitutions you can make to ensure adequate nutritional intake.
Plus, most health care providers recommend taking a pregnancy multivitamin to fill any nutritional gaps.
Speaking of vitamins, you should be taking your prenatal vitamins on a daily basis to get all the vitamins and nutrients both you and your baby need at this stage.
If you insist on counting and limiting calories during your pregnancy, make sure you’re not consuming any less than 1700 calories a day. Any lower than 1700 calories a day means not enough energy levels provided for you and your baby.
3) Exercise Safely
While many pregnant women continue to run, swim, and even lift weights, there are limits to safe exercise while expecting. Plus, every woman’s body is different, as are her physical limits, so there’s a lot of variation to what’s considered safe.
In most cases, your doctor will make it clear to you whether or not they agree with you continuing to do the same activities and sports you did pre-pregnancy.
However, starting a new sport or activity can pose risks to your developing baby, so it’s best if you hold off on running your first marathon until after you recover from birth.
Still, regular exercise during pregnancy can improve your health, reduce your odds of gaining excessive weight, help with back pain, and even make delivery easier.
In general, you can safely participate in many exercises while pregnant, such as:
- Brisk walking
- Swimming (just avoid hot tubs for your safety)
- Stationary cycling
- Low-impact aerobics
- Squatting and pelvic tilts (great for labor prep!)
4) Focus on Burning Calories
Overall, most low-impact activities are safe and beneficial for pregnant women, and regular exercise burns calories.
While you won’t want to exercise for hours per day, keeping your heart rate up will burn off calories and contribute to overall weight loss.
You can change your eating habits all you want, but if you don’t incorporate physical activity into your routine, you may not see any noteworthy weight loss effect.
5) Don’t Skip Meals
Although skipping meals may seem tempting when you’re trying to lose weight, it’s not healthy for you or your baby.
Not only do you need the energy for daily activities and helping your baby grow, but skipping eating can also make you more likely to gain weight, especially if it causes you end up binge eating later.
Plus, not eating for a long time might make your body hold onto the calories it does take in for fear of starvation.
Most experts, including nutritionists, agree on small, nutrient-dense meals consumed throughout the day rather than the traditional three well-rounded meals we usually eat.
Of course, you could also snack throughout the day whenever you feel hungry, as long as you’re eating healthy foods and are keeping track of calorie count.
6) Manage Any Medical Conditions
Because women who are overweight or obese are more likely to develop medical conditions than their average-weight peers, consulting with your doctor is an essential step in losing weight safely.
Before you begin exercising or changing your eating habits, you’ll want to know whether you have any conditions which will affect your ability to do so safely.
For example, gestational diabetes means high blood glucose (sugar) levels during pregnancy. Women with gestational diabetes will need to not only control their carbohydrate (sugar) intake, but they also need to understand how to check and treat low blood sugar levels.
Untreated gestational diabetes can increase your baby’s risk of being born overweight, having low blood glucose levels at birth, and developing breathing problems.
Babies born with too much insulin in their blood (the cause of low blood sugar) are also at higher risk for both obesity and type II diabetes.
Therefore, it’s crucial for expecting moms who are overweight to check with their doctors regarding any necessary testing and diagnosis of underlying conditions. Treating those issues can help make weight loss both easier and safer.
7) Pay Attention to Portion and Serving Sizes
One of the issues many people, pregnant or not, have with weight loss is figuring out how much to eat. Our society relies on the motto “bigger is better,” so it’s not uncommon to find huge food portions at restaurants and in packaged foods.
There is a difference between portion sizes and serving sizes, however. A serving size is what’s on the label of a product and outlines nutritional content per serving. Portion sizes are the standards by which our diets are measured; for example, a portion of grains equals half a cup of rice or pasta.
Ideally, pregnant women should focus on fresh foods, but for packaged items, it’s often okay to indulge – as long as you consume proper portions.
Stick to one (small) serving of treats and sugary items if you must have it, and you should remain within your calorie count and nutritional balance for the day.
In general, you should try to stick with smaller portion sizes. If you still feel hungry, aim to fill up with vegetables and fruit rather than higher-calorie foods that won’t make you feel nearly as full.
Here are some examples of portion sizes to help fill out your daily nutritional plan.
- Grains: one slice of bread or half a cup of rice or pasta
- Fruit: a small apple, ¾ cup of fruit juice
- Milk products: one cup of milk or yogurt or two ounces of cheese
- Meat: two to three ounces (the size of a deck of cards)
8) Enlist support
Having healthy support can help you stick with eating and exercise habits. Plus, if you and your partner team up, you can both be healthier and potentially happier when the baby arrives.
9) Take It Slow
You can’t expect changes to happen overnight. That’s calling for a miracle that will never happen – not safely, at least.
Dropping too much weight too fast can also have adverse health effects, especially in the context of a pregnancy.
What to Avoid Doing While Losing Weight During Pregnancy
In addition to our guidelines above, there are a few things you should absolutely avoid doing while trying to lose weight during pregnancy.
Of course, this list is not exhaustive, and you should always follow the advice of your medical team.
1) Keep Away from Keto
With the most recent rush of fad diets, plenty of women are aiming to lose weight by whatever means possible. But such diets can create health problems of their own, although they may help with weight loss (at least temporarily).
For example, the “keto diet” relies on consuming the fewest number of carbohydrates possible in a period of 24 hours.
While in theory this will help people lose weight, consuming too few carbohydrates can cause your body to enter ketosis.
Ketosis is where the “magical” weight loss happens, which is where your body begins to break down fat instead of carbohydrates for energy. When you’re pregnant, this isn’t ideal.
In fact, high levels of ketones during pregnancy (tested via your urine) can lead to pregnancy complications such as ketonuria.
The same advice on avoiding keto diets applies to other types of diets and fads as well.
Unless you’ve met with a dietician, nutritionist, or other healthcare professional regarding your weight loss nutrition, you shouldn’t subscribe to any “diet” plans.
2) Skip Nutritional Drinks and Supplements
There are tons of supplements out there which claim to help people achieve a variety of results, weight loss being the most popular.
And while some may have true merit, others can be ineffective and even dangerous. This is particularly true of pregnant women, as most supplement companies do not test their products on expectant moms.
Others explicitly state on their label that this product should not be consumed by pregnant women, regardless of whether they’ve tested or not.
It’s possible for you to purchase a supplement or product and bring it to your doctor or nutritionist for them to investigate further. However, in general, it’s a good idea to stay away from supplements and packaged nutrition and instead rely on fresh, nutritious food for your caloric intake.
Who Should Lose Weight While Pregnant?
Unless specified by your doctor, don’t attempt to lose weight during your pregnancy on your own.
All pregnant women should work with their healthcare provider to navigate weight loss and any factors unique to their pregnancy, health status, and lifestyle.
Read on for details on who is a good candidate for shedding some pounds while pregnant.
When Is It Safe For Me To Lose Weight While Pregnant?
In general, losing weight while pregnant is safe for women who are accurately classified as overweight or obese – unless they have specific problems or medical conditions that deem they should not lose weight at this time.
Studies have shown positive results with overweight moms who lost weight during pregnancy, including reduced odds of having a larger-than-normal baby.
Another study examined obese moms who had gestational diabetes, splitting the moms into two groups: one followed the standard diet for gestational diabetes, and the other used diet and exercise to control their weight.
The study determined that moms who used the diet and exercise guidelines lost less weight and maintained their weight better than the moms who followed the diabetic diet. Also, more moms who gained weight during pregnancy delivered their babies by Caesarian section than moms who lost weight or kept it constant.
One doctor involved in the study, Dr. Raul Artal M.D., the chair of the department of obstetrics, gynecology, and women’s health at Saint Louis University, noted, “We found that obese women do not have to gain any weight, and, in fact, can lose weight and it won’t hurt the baby. Pregnancy is an ideal time to start an exercise and fitness program, particularly for women who are obese.”
Overall, it appears to be perfectly healthy for overweight and obese moms (even those with gestational diabetes) to safely lose weight while pregnant.
To make extra sure and be on the safe side, talk to your doctor about this before you give it a go.
The U.S. Centers for Disease Control and Prevention (CDC) advises that you consult with an expert and receive counseling before you conceive, so that you have a clear plan of action right from the very beginning.
A Quick Note About The First Trimester
In the first trimester, most pregnant women are likely to experience some degree of weight loss, whether they’re intentionally trying to do so or not. Morning sickness that rears its ugly head can be difficult to deal with, especially when accompanied with intense nausea and vomiting that leave you with a much smaller appetite.
There’s not much to this that overweight women should be worried about, since they have an extra reserve of calories in their fat tissue that baby can tap into whenever needed.
If you notice you’re losing weight fast during your first trimester because you can’t seem to keep the food you eat down, get in contact with your doctor about this.
When Is It Not Safe For Me To Lose Weight While Pregnant?
Gaining too little weight or dropping some pounds during pregnancy might increase the risk of premature birth and mean a smaller than normal baby, along with other complications that might arise as well.
However, generally speaking, doctors agree there are more benefits to moms-to-be losing weight than there are risks involved.
Of course, losing weight while pregnant is unsafe if it happens because of a medical condition or a side effect of certain medication you might be taking at the time.
Also, for moms with pre-existing conditions, medications or treatments you’re taking can make it unsafe for you to exercise or change your eating habits.
Plus, although the above studies followed women with gestational diabetes who were obese, not every mom with GD should try to get that number on the scale down when pregnant. Many moms who are learning to manage their blood sugar or who require insulin or other medication for their diabetes may not be able to lose weight safely.
If you have a pre-existing condition, unexplained pain or worrisome symptoms, you should always discuss those with your doctor.
You should also consult with your doctor before changing up your eating and exercise habits, just to make sure weight loss during pregnancy is safe for you.
Wrapping It Up
With all the conflicting information out there, it can be challenging to figure out how to handle weight loss safely during pregnancy.
Fortunately, for most pregnant moms-to-be, it’s safe and even beneficial to drop some extra weight while expecting your baby.
It may not be the easiest thing to do, but the payoff is more than worth it, especially if you keep up your new healthy habits postpartum as well.
The key is to lose weight safely, just like anything else you do during pregnancy.
If you follow your doctor’s orders, stick to the right nutritional guidelines and make healthy choices in both food and fitness, you can expect great results for both your body and your baby.