So many American women begin pregnancy with extra weight that some doctors are questioning whether standard pregnancy weight-gain guidelines should be lowered. The guidelines, issued by the Institute of Medicine, suggest that underweight women gain 28 to 40 pounds during pregnancy, normal weight women gain 25 to 35 pounds, overweight women gain 15 to 25 pounds and obese women gain at least 15 pounds.
“The upper limits on the weight gain guidelines seem high to me,” says Sharon Phelan, M.D., a professor of obstetrics at the University of New Mexico in Albuquerque. “I tend to recommend the lower end of the range for most folks.” But instead of worrying how much to gain, she says, pregnant women should just focus on eating 2,000 to 2,500 calories per day of nutritious food.
“Pregnancy is not a time to lose weight, but a time to eat healthy foods appropriately and gain the weight needed to ‘feed’ the fetus,” says Phelan. Excess weight gained during pregnancy is difficult to lose afterward, she adds, and when women gain extra pounds with each pregnancy, they can become significantly overweight, increasing the risk for many health problems.