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If you’re living with obesity, you may often hear advice about eating less and moving more. Making healthy lifestyle changes can benefit your overall well-being — but when you find out you’re pregnant, your priorities may shift. You might wonder: Is it safe to lose weight during pregnancy if you’re overweight?
The answer: It depends. Pregnancy is a time to focus on healthy habits. It’s not a time to intentionally lose weight, especially with restrictive diets that can deprive you and your baby of essential nutrients. Nonetheless, if some weight loss happens because of morning sickness or healthier eating habits, that’s generally OK.
It’s important to share your goals and concerns with your healthcare provider. Only they can give you medical advice on managing your weight during pregnancy. Here are some basic tips to keep you and your baby safe.
Unless your healthcare provider specifically tells you otherwise, you shouldn’t attempt to lose weight during pregnancy. This is true no matter what you weighed before conception. Although obesity raises the risk of certain complications in pregnancy, losing weight while pregnant may not reduce these risks.
The guidelines for weight gain during pregnancy vary depending on your starting weight. Here’s what’s recommended based on your prepregnancy body mass index (BMI):
These numbers apply to pregnancy with one baby. Higher weight gain is recommended for those having twins.
Most of the weight gain in pregnancy should happen starting with week 14. There’s no need to eat more calories or try to gain weight during the first trimester. After that, most people with overweight or obesity should aim to gain about 1 pound every two weeks throughout the second and third trimesters.
Everyone’s pregnancy is different. These guidelines provide a good starting point but don’t always apply to real life. Studies show that about 1 in 3 women gain the recommended amount of weight while pregnant, according to the Centers for Disease Control and Prevention (CDC). About half gain more than the recommended amount, and 20 percent gain less.
Stay on track with doctor appointments to manage your risks. Remember, your healthy pregnancy may look different from someone else’s.
Obesity during pregnancy puts you in a higher risk category, which means your care team will likely recommend extra tests and monitoring to help ensure a safe pregnancy and delivery. Avoiding weight gain beyond the recommended amount can help lower your risks, but what matters most is staying in close contact with a knowledgeable healthcare provider.
Losing weight is generally not recommended, as it could introduce complications. Research shows that losing more than about 2.2 pounds during pregnancy may raise the risk of having a baby with a low birth weight.
“Small for gestational age” is the medical term for a baby who’s smaller than expected for the number of weeks of pregnancy. Babies born too small may have trouble with development, body temperature, or blood sugar levels. During pregnancy, obstetricians use ultrasound to monitor the baby’s growth. If there are signs of problems, they may recommend steps to help the baby grow before birth. Otherwise, special care after delivery may be needed.
In some cases of severe obesity (a BMI over 40) before pregnancy, gaining less than usual — or even maintaining weight — may not always be a cause for alarm. Minimal weight gain or slight weight loss may still lead to healthy outcomes. However, if there’s no weight gain at all, doctors will typically monitor fetal growth to ensure the pregnancy is progressing safely.
Restricting calories too much or cutting out entire food groups during pregnancy can lead to nutrient deficiencies, which can have lasting consequences for you and your baby. If you become pregnant while taking a medication like semaglutide (Ozempic, Rybelsus, or Wegovy), talk to your doctor right away. Many weight-loss and diabetes medications haven’t been fully studied in pregnancy and may need to be paused until after you give birth.
Worrying about losing weight while pregnant isn’t helpful. Instead, focus on getting enough nutrition, rest, and exercise. Healthy habits help reduce the risk of pregnancy complications such as preeclampsia and gestational diabetes.
Your body needs more nutrients during pregnancy to support both you and your growing baby. Start taking a prenatal vitamin as early as possible — ideally before you get pregnant. You’ll need enough calcium to build your baby’s bones and prevent yours from getting weaker. You’ll also need more iron because pregnancy increases your body’s blood volume.
Along with supplements, food choices matter. Aim to include lean proteins, whole grains, fruits, and vegetables in your meals every day. Try to limit sugary drinks and ultra-processed foods. Prioritize nutrient-dense foods that give your body what it needs without extra calories that may contribute to excessive weight gain.
Tracking your food and weight changes can be helpful, especially if your pregnancy is considered high risk. Your healthcare professional can help you decide on your best course of action. Consider meeting with a registered dietitian if you’d like more support for healthy eating during pregnancy.
There are a lot of misconceptions about exercise during pregnancy, but staying physically active is usually safe and often beneficial. Regular physical activity can help you feel better, reduce your risk of complications, and support a better recovery postpartum (after delivery).
If you weren’t active before pregnancy, this can still be a good time to start. Gentle options like walking, prenatal yoga, and water exercise can help you ease into movement. Over time, you can work toward the recommended 150 minutes of physical activity per week.
If you were already doing more intense workouts before pregnancy, you might need to adjust your routine. Talk with your healthcare provider about what’s safe for you and your baby. They can help you find a balance between staying fit and protecting your health throughout your pregnancy.
On MyObesityTeam, people share their experiences with obesity, get advice, and find support from others who understand.
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