How is obesity managed during pregnancy?

Pregnancy and obesity can be a challenging combination. But a healthy pregnancy is possible by properly managing weight gain, taking good care of yourself, and working closely with your healthcare provider. Here are some important tips:

  • See a healthcare provider before pregnancy. If you're overweight, meet with a doctor or midwife for a physical and preconception counseling before you get pregnant if you possibly can. Early visits give your healthcare provider a chance to educate, screen for risks, and evaluate any medications you're taking. Also, your provider will probably suggest that you try to reach a more healthy weight several months before conceiving.
  • Watch your weight, but don't diet. Once you're pregnant, your healthcare provider will probably discourage you from going on a weight-loss diet. Restricting your food intake is potentially hazardous to you and your developing baby. Your provider may suggest the same 2,000-calorie-per-day diet he would recommend to any other woman.
  • That said, in the first trimester, it's common to lose weight as the result of morning sickness: The nausea can diminish your appetite, and the vomiting can cause you to miss out on calories. But don't worry, your baby will still get all the necessary calories. Overweight women have an extra reserve of calories in stored fat, so as your baby grows, it's okay for you to maintain or even lose a little weight in the first trimester.
  • Eat healthy. Ask your healthcare provider about seeing a nutritionist who can help you adopt healthier eating habits, direct you to foods that will satisfy your hunger, and suggest nutrient-packed meals that will help your baby grow.
  • "An overweight woman has to focus on what they call a nutrient-dense diet. Foods that are nutrient dense, such as whole grains, beans, vegetables, low-fat dairy, and lean protein, provide a high nutrient-to-calorie ratio. Foods with low nutrient density have a lot of fat and sugar but basically no other nutrients," says ob-gyn Abel-Bey.
  • You can use our handy pregnancy food diary to make sure you're getting enough nutrients and drinking plenty of water every day.
  • Exercise: Unless there's a medical reason not to exercise, moderate exercise of 30 minutes or more several days a week is recommended. Ideally, start exercising before you become pregnant. Studies show that physical activity in morbidly obese women (BMI greater than 35) can help reduce the risk of developing conditions in pregnancy such as gestational diabetes.
  • Be sure to consult your caregiver before starting any sort of exercise program. And stop exercising immediately if you have any of these symptoms: vaginal bleeding, shortness of breath before exercise, dizziness, headache, chest pain, muscle weakness, calf pain or swelling, preterm contractions, leaking of amniotic fluid, or your baby isn't moving as much.
  • For more information, read our article on pregnancy exercise for beginners.
  • Attend prenatal appointments. Your healthcare provider will monitor you and your baby closely during pregnancy by checking your blood pressure and discussing recommended weight gain, and using ultrasounds and fetal heart monitoring to check on your baby. You may also be screened twice for gestational diabetes, first at the beginning of your pregnancy and again in your second or third trimester.
  • Get more tips from our article on how to manage your weight during pregnancy.