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'Eat for two' is outdated advice
How much weight should women gain during pregnancy? It depends.

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Date published: 9/6/2009


Pregnancy can be a magical time in a woman's life. Then comes the scale.

Stafford County mom Cristina Gonzalez was thrilled to learn of her second pregnancy earlier this year, but her medical chart lists her as "high risk" because she is obese.

Sally Bennett, also of Stafford County, gained 40 pounds with each of her four pregnancies. She bounced back to her pre-pregnancy weight fairly easily until baby boy No. 4. More than two years after his birth, she's still carrying about 20 extra pounds of what can no longer be called "baby fat."

Then there's Maggie Baumann, who was underweight when she became pregnant with her second daughter. She risked both her own and her baby's health by obsessively exercising throughout the pregnancy because she feared gaining weight.

New federal guidelines released earlier this year give specific ranges of recommended weight gain for pregnant women who are at normal weight, underweight, overweight or obese. Even the heaviest women should gain at least 11 pounds, according to the new recommendations.

Still, many pregnant women struggle with fear of weight gain, strange cravings and mixed advice from well-meaning family members and friends. And the "eating for two" myth persists.


Some weight gain is essential for a healthy pregnancy, say the new guidelines, an update of 1990 advice given when obesity rates were lower. But gaining more than the recommended amount can lead to health problems for both mothers and children.

For moms, those problems include excess weight to shed after the baby's birth, and increased risk for a Cesarean section. For babies, too much maternal weight gain can result in their being born early or born larger than normal, with excess fat.

While those problems might not sound too grave, "each of these consequences increases the chances for subsequent health problems," say the guidelines.

These include higher risks of heart disease and diabetes for those with extra weight, and impaired development for those born prematurely.

Gonzalez, 34, is 5 feet 2 inches tall and weighed 229 before pregnancy, putting her into the obese category.

The first thing that popped into her mind when the pregnancy test registered positive wasn't weight gain.

"I'm already overweight, so I'm sort of like, 'whatever,'" Gonzalez said.

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Healthy American women at a normal weight--which is a body mass index of 18.5 to 24.9--should gain 25-35 pounds during pregnancy, according to the Institute of Medicine.

The range for underweight women is 28-40 pounds. Overweight women with a BMI between 25 and 29.9 are advised to gain 15-25 pounds, and for obese women with a BMI of 30 or higher, the advice is to gain 11-20 pounds during pregnancy.


Updated pregnancy weight gain guidelines are available at nap.edu/catalog.php?record _id=12584.

Calculate your BMI at nhlbisupport.com/bmi.

Read healthy eating tips and other pregnancy-related advice from the Centers for Disease Control and Prevention at cdc.gov/ncbddd/bd/abc.htm.

Tips on exercise during pregnancy are posted at kids health.org/parent/nutrition _fit/fitness/exercising_preg nancy.html.