The institute of medicine is widely recognized as setting guidelines for pregnancy.  The last time they revised their estimates was in 1990.  Since then the obesity epidemic has boomed.  Kathleen Rasmussen, ScD, PhD, and IOM committee chairwoman expressed “during pregnancy many women gain substantially more than we would like.”  The new guidelines are similar to the past, but now the obese women have an upper limit.  No one should lose weight while pregnant.

So what is the magic answer?

First, figure out your BMI.  Body mass index.   weight (pounds) / [height (ininches)]2 x 703.  For those who don’t want to do the math, go to the calculator here:  This is a fairly reliable way of figuring out body “fatness” in most people. It doesn’t directly measure your fat, but research has shown BMI correlates with accurate measurements of body fat.

What are the categories?

  • If your BMI is less than 18.5= underweight
  • BMI is 18.5 to 24.9= normal or healthy
  • BMI is 25.0 to 29.9= overweight
  • BMI is 30.0 or higher= obese


SO. the IOM guidelines?


If you are pregnant with ONE child:

  • Underweight: Gain 28-40 pounds
  • Normal weight: Gain 25-35 pounds
  • Overweight: Gain 15-25 pounds
  • Obese: Gain 11-20 pounds

If you are pregnant with TWINS :

  • Underweight: no guidelines due to insufficient data
  • Normal weight: Gain 37-54 pounds
  • Overweight: Gain 31-50 pounds
  • Obese: Gain 25-42 pounds

So most likely,  to do this, you need to eat basically what is your normal.  Exercise.  Don’t think of this time as “eating for two.”  If you do, in addition to gaining more weight than you should (which leads to a host of other issues), you will be hurting your body’s ability to bounce back after pregnancy.  Trust me- as a plastic surgeon, I see it all the time.