Can Women with Obesity Lose Weight During Pregnancy?

Obese woman sitting on bed holding pregnancy test
February 19, 2024
The intersection of obesity and pregnancy presents unique health challenges and concerns. Obesity during pregnancy is associated with increased risks for both the mother and the unborn child, including gestational diabetes, hypertension, and complications during delivery. Alongside these physical health concerns, there are widespread misconceptions and anxieties surrounding the topic of obesity in pregnant women. A common question that arises is whether it is safe or advisable for women with obesity to lose weight during pregnancy. Addressing this requires a nuanced understanding of the health implications and an exploration of the balance between maternal and fetal well-being.

Medical Perspective on Weight Loss in Pregnancy

Doctor talking with pregnant woman

Healthcare professionals typically approach weight management in pregnant women with obesity with a focus on optimizing health rather than pursuing weight loss. Insights from obstetrics and nutritional science underscore the importance of monitoring weight gain to ensure the health of both the mother and the developing fetus. Rather than advocating for weight loss, the emphasis is often on avoiding excessive weight gain and managing health conditions that could be exacerbated by obesity. This medical advice is not just about the numbers on a scale but about a comprehensive approach to health, setting the stage for practical strategies to manage weight during pregnancy.

Safe Weight Management Strategies for Plus Size Pregnancy

Pregnant woman working out with daughter on yoga mat

When discussing weight management in pregnancies of women with obesity, dietary considerations are paramount, especially in that our current antiobesity medications are not to be taken during pregnancy. That said, there is no unique dietary strategy that will support everyone, just as there is no one right diet that works for everyone. But given the increased nutritional considerations of pregnancy, it would be important if adopting a new diet, to ensure that a medical or dietetic health professional is consulted to ensure that nutritional needs of both mom and fetus are being met. Exercise is also of course advisable, even if it isn’t likely to impact weight directly. Increased exercise, if realistically doable within a person’s life, of course would need to be  appropriately tailored to the individual's condition and pregnancy stage, and can play a significant role in maintaining overall health and well-being. A holistic approach to weight management combines both dietary strategies and physical activity, ensuring that the focus remains on health rather than weight loss per se.

Nutrition and Diet Considerations

Nutritional guidelines for pregnant women with obesity should prioritize balancing caloric intake with the need for essential nutrients. This means focusing on a diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. Portion control and mindful eating are also important, as they help manage caloric intake while ensuring that the mother and baby receive adequate nutrition. Just as with non-pregnancy related diet considerations, recommendations often include avoiding empty calories and highly processed foods, emphasizing the quality of the diet over mere calorie counts, and again, there are many different dietary approaches that can help achieve same. 

Exercise and Physical Activity

Exercise is safe and healthy for pregnant women with obesity. The key is to find activities that are enjoyable and sustainable. If you have concerns about exercising during your pregnancy we would encourage you to discuss those concerns with your primary care provider.

Emotional and Mental Health Support During Pregnancy

The emotional landscape of being pregnant and having obesity can be complex. Pregnant people with obesity regularly face societal stigma, and may also face personal insecurities, and heightened anxiety about their health and the health of their baby. It's essential to address these emotional challenges and stress the importance of mental health support. This support can come from counseling, support groups, or healthcare providers specializing in maternal mental health. 

Final Thoughts

Page in a typewriter that says Final Thoughts

For many people with obesity, the stresses, and risks, associated with pregnancy can be heightened. That said, each pregnancy is unique, and advice should be personalized to fit the individual's specific health needs and circumstances. Reassurance comes from knowing that with the right support and care, people with obesity can navigate their pregnancies healthily and safely.

Frequently Asked Questions

What are the risks associated with obesity and pregnancy?

Risks include gestational diabetes, preeclampsia, higher likelihood of cesarean delivery, and complications for the baby.

How much weight gain is recommended in pregnancy for people with obesity?

The recommended weight gain varies based on the individual's BMI but general recommendations often cite a 12-20lb gain.

Are there specific dietary plans recommended for pregnant patients with obesity?

Just as for people with obesity who aren’t pregnant, dietary plans typically focus on nutrient-dense foods, controlled portion sizes, and balanced meals to ensure both the mother and baby receive essential nutrients without excessive energy  intake.

Dr. Yoni Freedhoff
Medical Director
Since 2004, Dr. Yoni Freedhoff, an Associate Professor of Family Medicine at the University of Ottawa, has dedicated his practice to obesity medicine. ‍ Canada's most outspoken obesity expert, Dr. Freedhoff is regularly sought out by the international media for commentary on nutrition and weight matters, and his book, The Diet Fix: Why Diets Fail and How to Make Them Work. Dr. Freedhoff's diet agnostic philosophy and lessons learned from working with over 10,000 patients is the foundation of what Constant Health has been built upon.
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