Weight Gain during Pregnancy

It is normal to gain some weight during pregnancy as a result of the hormonal and other changes occurring in your body. But, gaining too much or too little weight can be harmful for you and your baby ^[1]. So, it is essential to know the healthy weight gain levels and how to achieve them. The recommended amount of weight to be gained during pregnancy varies from one woman to another depending mainly on their BMI (body mass index) before pregnancy. According to a pregnancy myth, if the extra calories tend to accumulate only in the belly area you are having a boy, while gaining all around the middle means it is a girl ^[2].

Is weight gaining an early sign of pregnancy?

Weight gain is not an early sign of pregnancy as it often does not become evident before the second trimester.

How much weight should you gain during pregnancy?

It is erroneously believed that you are eating for two (you and your baby) when you are pregnant. Recent researches show that a pregnant woman needs only 300 additional calories (around 500 in twin pregnancy ^[3]) in a day, which can be acquired from an extra bowl of cereal or half a sandwich ^[4]. So, it is not advisable to tuck in sugary treats and calorie-rich foods that make you gain weight without providing any additional nutritional value.

When the weight gain is centered on your belly area, it is baby weight. Experiencing weight gain in the hips, thighs and legs can indicate the presence of excess weight ^[5].

Recommended Weight Gain Levels

IOM or The Institute of Medicine published revised guidelines regarding the appropriate amount of weight gain during pregnancy based on WHO’s (the World Health Organization) body mass index (BMI) chart.

Pre-pregnancy BMI	Recommended Weight gain ^[6]
Underweight (BMI below 18.5)	28 to 40 pounds (13 to 18 kg)
Normal Weight (BMI between 18.5 and 24.9)	25 to 35 pounds (11.5 to 16 kg)
Overweight (BMI between 25 and 29)	15 to 25 pounds (7 to 11.5 kg)
Obese (BMI over 30)	11 to 20 pounds (5 to 9 kg)

Twin Pregnancy Weight Gain Chart

Pre-Pregnancy BMI	Recommended Weight Gain ^[7]
Normal Weight	37 to 54 pounds (17 to 25 kg)
Overweight	31 to 50 pounds (14 to 23 kg)
Obese	25 to 42 pounds (11 to 19 kg)

When do you start gaining weight in pregnancy?

A pregnant woman typically starts gaining weight later during the first trimester (mainly retained water) ^[8], although the weight gain remains minimal at this early stage. There is generally little or no increase in weight during the first month (as the baby is still just a tiny ball of cells), while women suffering from severe morning sickness may even lose weight during the initial months.

Most mothers gain the highest amount of weight in the second trimester (eating habits in this period materially influence the baby’s birth weight) ^[9], while considerable weight gain occurs during the third trimester as well. However, it may slow down during the last month ^[10] due to various reasons (not being able to eat much or having an active baby).

Second Pregnancy Weight Gain

Most women tend to start putting on weight earlier in second pregnancies while the total amount of weight-gain may be higher as well.

Average Pregnancy Weight Gain Timeline by Trimester and Week

This is how the extra pounds are expected to be distributed throughout a healthy singleton pregnancy ^[19]:

BMI	First Trimester (total weight gain)	Second and Third Trimesters/Week
Underweight	1 to 4 pounds	1 to 1.3 pounds
Normal Weight	1 to 4 pounds	0.8 to 1 pound
Overweight	1 to 2 pounds	0.5 to 0.7 pound
Obese	0 to 1 pound	0.4 to 0.6 pound

Pregnancy Weight Gain Breakdown Chart

Here is how the extra weight adds up in pregnancy ^[11]:

Baby	7.5 pounds
Womb	2 pounds
Placenta	1.5 pounds
Amniotic fluid	2 pounds
Fat and Protein	7 pounds
Blood	3 pounds
Retained water	4 pounds
Breasts	2 pounds

Best Ways to Gain Healthy Weight during Pregnancy

Eating 5-6 small meals throughout the day instead of three large ones
Having peanut butter occasionally along with crackers, toast, apples and celery (1 tablespoon peanut butter contains around 100 calories and 7 gm protein) ^[12]
Including good sources of fat and nutrients, like cream cheese, butter, gravy and sour cream, in your daily diet
Drinking healthy calorie-rich beverages like smoothies and protein shakes ^[13]
Lightening up the exercise routine to reduce the amount of calories burnt ^[14]

How to not gain excessive weight during pregnancy?

It might be a difficult task to control the weight gain while pregnant. But it is vital to keep the body weight within the ideal range to avoid complications such as sleep apnea ^[15], preeclampsia (high blood pressure), gestational diabetes, back and leg pain, macrosomia (big baby) and c-section delivery ^[6]. It is never advisable to adopt any weight-loss diets while carrying as crash and low-calorie diets can lead to malnutrition. The following guidelines can help you gain the minimum weight so that you can go back to your pre-pregnancy weight shortly after delivery.

Maintaining a balanced diet (consult your doctor regarding the best diet for you) ^[16]
Eating foods such as fresh fruits and vegetables (e.g. avocados, beans), high calorie legumes and grains, yoghurt, whole-grain breads, cereals, ^[14] fish and lean meat as they are excellent sources of healthy fats
Choosing foods that are both nutritious and satisfying (e.g. brown bread for the white variety and brown rice for white rice) ^[5]
Giving up alcoholic beverages; fruit juices containing beta carotene or vitamin C and are healthy alternatives (orange, grapefruit and papaya) ^[19]
Snacking on healthy foods like nuts, low-fat cheese, wholegrain crackers and dried fruits instead of fatty or sugary treats ^[6]
Maintaining an active lifestyle containing regular exercise and yoga (in case you tend to gain too much weight) ^[11]

Do prenatal vitamins make you gain weight?

Prenatal vitamins contain essential nutrients like folic acid that does not add any additional calories to your diet. So, taking the vitamins does not contribute to gaining excess weight.

When to call the doctor?

Sudden considerable weight gain within 1-2 days ^[17]
Rapid weight gain measuring over 2-4 pounds a week ^[18]

The above two symptoms might indicate complications like preeclampsia and gestational diabetes ^[8]. Babies born to mothers suffering from gestational diabetes often gain more weight and are larger than normal, requiring a c-section delivery ^[20].

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