Prof Arshad Rather, MSC, FRCP
Weight loss expert Consultant
Pregnancy is one of the most exciting chapters in life, but it can also bring big changes to your body and health. Managing weight around pregnancy isn’t just about fitting into clothes; it’s about keeping both you and your baby healthy. This guide will walk you through weight management before, during, and after pregnancy, and explain how healthy lifestyle habits (and in some cases, safe medications) can help.
Before Pregnancy: Preparing Your Body
Why it matters:
– Lowers risk for gestational diabetes, preeclampsia, caesarean delivery, and abnormal baby size.
What the research says:
– Women with BMI 18.5–24.9 before pregnancy have lower complication rates.
– Even 5–10% weight loss before pregnancy can improve fertility and health.
How to prepare:
- Balanced nutrition: whole grains, lean proteins, fruits, vegetables, healthy fats.
- Regular movement: 150 minutes of moderate activity weekly.
- Medical support: Consider weight-loss medications or programs before pregnancy if BMI ≥ 30.
During Pregnancy: Healthy Weight Gain
The goal:
You are not ‘eating for two’ you’re eating for one healthy adult and one growing baby. Weight gain is normal and necessary, but the amount matters.
Recommended total weight gain (Institute of Medicine):
– Underweight (BMI < 18.5): 28–40 lbs (12.5–18 kg)
– Normal weight (BMI 18.5–24.9): 25–35 lbs (11.5–16 kg)
– Overweight (BMI 25–29.9): 15–25 lbs (7–11.5 kg)
– Obese (BMI ≥ 30): 11–20 lbs (5–9 kg)
Key tips:
– Focus on nutrient quality, not just calories.
– Stay active unless advised otherwise.
– Avoid weight-loss medications during pregnancy.
After Pregnancy: Returning to a Healthy Weight
Why it matters:
– Helps prevent type 2 diabetes, heart disease, and future pregnancy complications.
The facts:
– Many women keep 10+ lbs a year after birth if weight gain was above guidelines.
– Gradual weight loss (0.5–1 lb/week) is safe, especially if breastfeeding.
Strategies:
- Balanced meals: small, frequent, nutrient rich.
- Physical activity: start with gentle exercises, add strength training gradually.
- Sleep & stress management.
Where Do Weight-Loss Medications Fit In?
Before pregnancy:
– If BMI ≥ 30 (or ≥ 27 with health issues), your doctor may prescribe medications such as GLP-1 receptor agonists.
– These can lead to 10–15% weight loss in 6–12 months when combined with lifestyle changes.
– Stop medications before trying to conceive.
During pregnancy:
– No weight-loss medications are safe. Focus on healthy eating and activity.
After pregnancy:
– Once not breastfeeding (or if approved by your doctor), medications may be considered again.
– Structured programs with nutrition support and medication can be effective.
Key messages from eGynaecologist
– Before pregnancy: Aim for a healthy BMI; even small weight loss helps.
– During pregnancy: Gain within recommended ranges; avoid weight-loss drugs.
– After pregnancy: Gradual, sustainable weight loss; medications may help if safe.
– Always work with your healthcare provider — every pregnancy is unique.
Bottom line: Managing your weight before, during, and after pregnancy is about health, not just appearance. With the right plan and medical support when needed, you can set yourself and your baby up for the healthiest start possible.
