Your Pregnancy Matters

New Year’s weight resolutions that are safe during pregnancy

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In general, women who start their pregnancy at a normal weight should gain 25 to 30 pounds.

We’re about a month into the new year, and many people are trying to stick to New Year’s resolutions that revolve around achieving a healthy weight.

That's great if you're optimizing your health before pregnancy or want to lose weight after the post-partum period. But weight loss during pregnancy is not recommended.

We know women who are overweight or obese are at increased risk of developing problems during pregnancy, such as gestational diabetes and preeclampsia, and experience higher rates of preterm birth, cesarean section (C-section), and postpartum hemorrhage.

However, weight management during pregnancy requires a delicate balance. It's unsafe for expectant mothers (and their babies) to take extreme measures to prevent excessive weight gain – sometimes called pregorexia. But it’s also unnecessary to “eat for two.”

A better resolution is to focus on managing weight gain. Another useful resolution – if you’re considering having a baby in the near future – is to lose some weight before becoming pregnant. Let’s talk about these two pregnancy resolutions and steps you can take to achieve them.

Resolution #1: Gain the recommended amount of weight

Gaining some weight during pregnancy is expected and healthy. However, 47 percent of pregnant women in the U.S. gain too much, according to the Centers for Disease Control and Prevention (CDC).

Your first step toward keeping this resolution is to talk with your doctor. Discuss how much weight you should gain based on your pre-pregnancy weight and your unique health condition.

In general, women who start their pregnancy at a normal weight should gain 25 to 30 pounds, while those who are overweight should gain 15 to 25 pounds. Patients who are obese are recommended to gain 11 to 20 pounds. 

Related reading: How to maintain a healthy weight during pregnancy

Obesity is defined as having a body mass index (BMI) of 30 or greater. For example, an active woman who is 5 feet 4 inches tall and weighs 180 pounds is considered obese based solely on the BMI of 30.9.

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

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

A person at a normal weight with a singleton pregnancy would have to eat about 3,500 excess calories a week to gain a pound. That's about 500 extra calories a day, which is approximately equal to one plain bagel with cream cheese or four slices of bacon.

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So, "eating for two" typically isn't necessary. Tracking your calories with an app may help you avoid going overboard. Or you can use nutritional services available at many health care centers, including UT Southwestern.

Partial meal replacement such as shakes or nutrition bars can be a good option for some women to limit their weight gain during pregnancy. Talk to your doctor or dietitian first about whether it is a safe and healthy choice for you.

recent study observed pregnancy weight gain in women who were overweight or obese. One group of patients substituted two meals a day with shakes or bars.

The group that consumed meal replacements was more likely to stay within the recommended guidelines for weight gain during pregnancy than those that chose their own meals. Patients who used the supplements had a lower likelihood of inadequate calcium intake and improved intake of some vitamins. 

Along with food, exercise is crucial to weight management. Your resolution could also include becoming more active. This doesn’t mean you need to start training for a marathon. Start with 30 minutes of moderate exercise five days a week, such as going for a walk around the neighborhood.

Related reading: You can exercise while pregnant – start now!

Along with keeping you and your baby healthier during pregnancy, increased activity also will set you up to take off the excess weight faster after the birth.

Resolution #2: Lose weight before you become pregnant

Taking steps to optimize your health before becoming pregnant can reduce the risk of adverse outcomes. This includes working to reach and maintain a healthy weight.

Much like the previous resolution, start by talking to your doctor. We can help you determine a healthy weight and pick a diet and exercise plan that’s practical for your life.

If you bite off too much at once, you may be setting yourself up for failure. Small steps are good and will get you where you need to be. This could mean eating more fruits and vegetables and cutting out a few extra carbs. Start walking 20 to 30 minutes a few days a week, and then gradually increase the time and intensity.

New Year’s resolutions – or resolutions made any time of the year – can be a wonderful opportunity to make positive changes in your life. And there are few better reasons to make a resolution than to improve your health and that of your baby.

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