Eating for two? How to maintain a healthy weight during pregnancy

During pregnancy, many women relish the opportunity to feed their sweet tooth or enjoy comfort foods that are full of empty calories. In fact, 47 percent of American moms gain too much weight during pregnancy, according to a report from the Centers for Disease Control and Prevention (CDC).

Some women think they have to eat for two during pregnancy, but overeating can lead to health problems for moms, such as diabetes and heart health concerns. And excessive weight gain during pregnancy makes it that much harder to lose the weight after birth, leading to an increased risk of obesity at the beginning of a future pregnancy. 

Of course, some weight gain is expected during pregnancy. However, it’s important to discuss with your doctor how much weight you should gain based on your weight before pregnancy and your unique health condition.

Determining your pregnancy weight

At the start of your pregnancy, calculate your body mass index (BMI) to help determine whether you are at a healthy weight. You might be surprised at what you learn. For example, an active woman who is 5 feet 5 inches tall and weighs 155 pounds is considered overweight (but not obese) based solely on BMI. Of course, there might be an unusual case of someone who is exceptionally fit and muscular who could fall into this category. But for most patients, this designation is accurate. 

How much weight gain is normal during pregnancy?

In general, pregnancy doesn’t cause weight gain in the first trimester, which is the 14-week span that begins on the first day of your last period. The American Congress of Obstetricians and Gynecologists recommends that women who start out at a healthy weight gain 25 to 35 pounds throughout the course of pregnancy, whereas those who start a pregnancy overweight gain no more than 15 to 25 pounds, and those who are obese gain no more than 11 to 20 pounds. 

I tell my patients who are at normal BMIs to break down the weight gain like this:

• Five pounds in the first half of pregnancy (or first 20 weeks)
• One pound per week thereafter

After delivery, it can be tough to lose the weight gained during pregnancy. You’ll likely be tired and experience some stress in caring for the newborn, which further complicates weight loss. However, carrying extra weight can result in long-term obesity, which contributes to a lot of health problems, such as:

• Heart failure
• High blood pressure
• Osteoarthritis
• Sleep apnea

How your health care team can help

The first step to help a pregnant woman maintain a healthy weight is the prenatal visit. A woman’s first prenatal visit always includes a weight check. We do this in the exam room to keep our patients’ weights private – a practice patients have praised on our patient satisfaction surveys.

We ask for a baseline weight for many reasons:

• To measure the ability to keep food down – I’ve seen patients with severe nausea and vomiting lose five to 10 pounds early in pregnancy
• To make sure you are gaining weight appropriately during the middle of pregnancy
• To watch for rapid weight gain from swelling, which can indicate preeclampsia, or high blood pressure during later pregnancy

When you arrive for your visits, wear everyday clothing and remove your shoes. This will help us most accurately assess your true weight.

Managing your weight at home

I advise women to monitor their weight gain at home during pregnancy, especially because early prenatal visits might be weeks apart. Here are some tips:

• Track your weight: You can keep track on paper or by using a digital tool such as the pregnancy weight tracker from the Centers for Disease Control and Prevention.
• Weigh yourself at the same time every day: For example, always weigh before or after bathing so there’s no confusion about the weight of clothing.
• Stay active: Combat the extra calories you might eat by getting the recommended 30 minutes of moderate exercise five days a week.
• Watch out for cravings: Go ahead and enjoy a pint of fresh raspberries every day. But be careful about the amount of Ben and Jerry’s Chunky Monkey ice cream you eat late at night! Try to choose nutrient-dense foods to curb your cravings.

Having a sweet tooth or other cravings during pregnancy is totally normal. I know how it can feel – I’ve been there. But the importance of keeping your calories in check and getting a steady dose of exercise can go a long way in ensuring your weigh-ins during prenatal visits are as expected, which can help pave the way for long-term health for you and your baby.

Stay on top of health care news. Subscribe to our blog today.