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How much weight should I gain during pregnancy?

Dr. Nancy A. Rector-Finney, MD
OBGYN (Obstetrician & Gynecologist)

A healthy weight gain during pregnancy is around 20 to 25 pounds. Watch Nancy Rector-Finney, MD, with Methodist Children's Hospital, talk about the different weight gains for different body types.

Paula Greer
Midwifery Nursing Specialist

Your recommended pregnancy weight gain is based on your BMI and whether you are carrying one baby or more than one. On average a normal health woman with one baby at a normal BMI of 19.8 to 26.0 should gain 25 to 35 pounds. If she is underweight with a BMI under 19.8 and has one baby she should gain 28 to 40 pounds. If a woman is overweight with a BMI of 26 to 29 and has one baby she should still gain at least 15 pounds. Obviously if she has more than one baby the weight gain will go up and should be discussed with her healthcare provider. Also if she is morbidly obese her weight gain and diet should be reviewed closely with her healthcare provider to ensure she gets adequate nutrition to grow a healthy baby but the right diet to prevent the complications that arise with obesity and pregnancy.

There is no magic number for how much weight you should gain during pregnancy. Every woman is different when it comes to height, weight, physical activity and metabolism. A healthy pattern of weight gain is about three to six pounds during the first three months of pregnancy and about a pound a week for the remainder of your pregnancy, but your healthcare professional will tell you the appropriate amount for you.

General guidelines from the Institute of Medicine (IOM) recommend that women who were underweight before getting pregnant gain 28 to 40 pounds during pregnancy; normal weight women gain 25 to 35 pounds; overweight women gain 15 to 25 pounds; and obese woman gain 11 to 20 pounds.

Women who are pregnant with twins are given special guidelines from the IOM. Those in the normal BMI category should aim to gain 37 to 54 pounds; overweight women, 31 to 50 pounds; and obese women, 25 to 42 pounds.

High weight gain during pregnancy is associated with a greater risk for cesarean section and higher than normal birth weight and moderately associated with weight retention later in life. On the flip side, low pregnancy weight gain can lead to infants with lower than normal birth weights.

Weight gain in pregnancy depends upon the mother’s prepregnancy weight. The table below (from the American College of Obstetricians and Gynecologists) tells us how much is recommended based upon the body mass index (BMI) of the mother. The heavier you start out, the less should be gained. A woman of normal weight should gain about 25 to 35 pounds for the entire pregnancy. Don’t worry if you don’t gain weight in the first trimester or even lose a little.

If you are carrying twins or triplets, talk with your physician about the appropriate weight gain.
 
Prepregnancy      Underweight     Normal Weight   Overweight   Obese

Body Mass Index Less than 18.5        18.5–24.9     25–29.9     30 and greater

Recommended Range of Total Weight (lb)
                                 28–40        25–35            15–25         11–20

Recommended Rates of Weight Gain in the 2nd and 3rd Trimesters (lb)
(Mean Range [lb/wk])

                                1 (1–1.3)    1 (0.8–1)      0.6 (0.5–0.7)     0.5 (0.4–0.6)

If you were an average weight before pregnancy, you should try to gain about 25 to 35 pounds during pregnancy. This weight gain seems to best nurture a mother and growing baby. At the minimum, a pregnant woman should gain 15 pounds. Women who were underweight before pregnancy may gain up to 40 pounds. Women carrying twins may gain as much as 45 pounds. Women who were overweight should limit their weight gain to 15 to 25 pounds.

Weight gain during pregnancy can be fairly variable. There are some women who will gain much more than they should and others that may not gain as much as they should. The best way to look at weight gain during pregnancy is that it's totally dependent on what your weight was when you went into pregnancy. If you are underweight, you might expect to gain 30 or 40 pounds or more for that to truly be a healthy amount of weight gain. If you are at a normal weight, then somewhere around 20 to 25 pounds is probably perfect. If you're actually overweight, you may only gain 5 or 10 pounds during the pregnancy, depending on how overweight you are. The best way to look at it is, while your calorie requirements go up during pregnancy, they don't go up as much as most people increase their intake. So it's important to watch weight and not gain excessively.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.