Gaining weight is critical during pregnancy to help your baby grow. But if your practitioner tells you that you're pacing a bit ahead of your recommended pregnancy weight gain, don’t panic.

When it comes to pregnancy weight gain, many women step on the scale and discover they’ve gained a bit more than what's recommended. In fact, 48 percent of American moms gain too much weight during pregnancy, according to a report by the Centers for Disease Control and Prevention (CDC).[1]

If this happens to you, know that you're not alone and gaining a little more weight than is recommended is generally not cause for concern. The problem arises if you gain well above your recommended weight gain throughout the course of your pregnancy.

How much weight should I gain during pregnancy?

This depends on your pre-pregnancy weight and body mass index (BMI). While there is some controversy about using BMI as a measurement for defining “healthy” weights, this data point is how research studies have been conducted and how the Institute of Medicine (IOM) categorizes recommended weight gain.

For this reason, experts continue to use BMI to define recommended weight gain ranges during pregnancy, but it's important to keep in mind that these measurements aren't perfect.

The general recommended pregnancy weight gain for a woman with a "normal"-range BMI (18.5-24.9) before she conceived is between 25 and 35 pounds. You should ideally gain a little more if you're underweight, a little less if you're overweight and even less if you have a BMI above 30 before you get pregnant.[2]

However, your doctor is the best one to assess your weight, metabolism and BMI, and tell you what you should be gaining throughout pregnancy and by trimester.

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How do I get my pregnancy weight gain back on track?

If you’ve raced past the target weight gain that your OB/GYN or midwife is discussing with you at your weekly appointments, you can aim to keep your gain on target for the rest of your pregnancy. These steps can help:

  • Talk to your practitioner. Your doctor or midwife can help you come up with a plan to watch the scale and what you eat. He or she may also suggest working with a nutritionist.
  • Skip the diets. Dieting to lose weight during pregnancy is never a good idea. Your baby needs a steady supply of nutrients, especially in the second and third trimesters. Also avoid appetite-suppressing drinks or pills, which can be very dangerous when you're expecting.
  • Cut empty calories. The emphasis is on empty — you still need to eat enough of the right kinds of calories to keep your baby growing. After all, the idea isn't to lose weight but to slow the rate at which you're gaining. Easy, nutritious, calorie-reducing strategies can make a big difference. Try smart substitutions: 1 or 2 percent milk instead of whole milk, fresh fruit instead of dried fruit, baked potatoes or yams for French fries, grilled white meat chicken with no skin instead of fried dark meat chicken with skin. Other calories that can go (or be limited)? The ones in sugary treats.[3]
  • Fill up on nutrients. Keep up with your pregnancy diet by eating the right quantities of the right, nutrient-packed foods. Watch portion sizes — a "serving" of any given food may be much smaller than you think, and a whole lot smaller than restaurants have led you to believe. For instance, did you know that a serving of meat or poultry should be about the size of a computer mouse and that a serving of cheese should be no bigger than a 9-volt battery?
  • Eat efficiently. Choose foods that are big on bulk (so they fill you up and keep you filled) but low on calories: fresh vegetables (especially leafy greens) and fruits (especially ones with a high water content, like melon); lean poultry, meat and fish; and oatmeal (a better choice than granola, which tends to pack a lot of sugar and calories into a small serving). And fill up on water, not soda or juice.
  • Focus on smart fats. Somewhere around 25 to 35 percent of all your daily calories should come from healthy fats to fill you up and build your baby. But not all fats are created equal. Stock up on plant-based monounsaturated fats (like olive oil, canola oil, peanut oil, safflower oil, sesame oil, avocados, nuts, seeds and nut butters) as well as polyunsaturated fats (including salmon, trout, flaxseed, tofu, walnuts, soybeans, canola oil and sunflower oil). The latter are also good sources of omega-3 fatty acids, which help build your baby’s heart, immune system, brain and eyes. Try to limit yourself to about 6 percent saturated fats (low-fat beef and high-fat dairy like butter and hard cheeses) in your daily diet. And minimize your consumption of trans fats — found in cookies, packaged baked goods, frozen pizza, crackers and fried foods — since they're empty calories that aren't so healthy for you or your baby.
  • Get active. With your practitioner's okay, make regular exercise a part of your pregnancy. While joining a prenatal yoga or exercise class is a great way to get and stay motivated, small amounts of activity add up fast and all count toward your recommended 30 minutes of daily physical activity. So incorporate some movement into your everyday routines: Park a few blocks from your destination and walk the rest of the way, take the stairs instead of the elevator and walk to the deli to pick up your sandwich instead of ordering in.[4]
  • Curb late-night snacking. Steer clear of satisfying your cravings or trying to soothe your nausea by snacking or eating meals late at night or in the middle of the night, as that can be a major reason for weight gain. Instead, try to prepare and eat healthier, smaller snacks earlier in the day. If you have to snack later in the evening, keep it nutritious and to a minimum.
  • Skip or limit juices and smoothies. Some pregnant moms may think juices and smoothies are healthy to drink, but they are often packed with sugar and calories. Limit how many fruity drinks you consume during pregnancy and be sure to read labels in prepared drinks first so you know what's in them.

What are the risks of gaining too much weight during pregnancy?

Gaining too much weight during pregnancy puts moms and their babies at risk for health problems both during pregnancy and after, including:[5]

  • Less accurate ultrasound results. If you are overweight during pregnancy and have too much body fat, your practitioner may have a harder time looking at your baby (and diagnosing any problems that might require treatment) during your ultrasound exams. That may mean you'll have longer exams and possibly more ultrasounds.
  • Increased discomfort. Let's face it, pregnancy isn't all that comfortable to begin with — and those discomforts tend to multiply with the pounds. Excess weight gain can result in or aggravate everything from backaches and leg pain to overall exhaustion, not to mention varicose veins, calf cramps, heartburn, hemorrhoids and achy joints. And if too many extra pounds follow you to labor, they can also make the experience tougher.
  • High blood pressure. Having gestational hypertension, which is diagnosed in the second half of pregnancy, can lead to issues during delivery.
  • Preeclampsia. Gaining too much weight can up your risk of preeclampsia. In turn, that condition can lead to liver and kidney problems for you as well as increase your risk of intrauterine growth restriction (IUGR), placental abruption and other complications. If you gain more than three pounds in any one week in the second trimester, or if you gain more than two pounds in any week in the third trimester — especially if it doesn’t seem to be related to overeating or excessive intake of sodium — check with your practitioner, as it could be a sign of preeclampsia. 
  • Gestational diabetes. Being overweight or gaining too much weight during pregnancy puts you at risk of gestational diabetes.
  • A large baby. The heavier you are, the more likely it is that you'll give birth to an overly big baby (macrosomia) at birth (which can also happen as a result of gestational diabetes). Macrosomia increases the odds that a vaginal delivery will require the use of forceps or vacuum and ups your chances of delivering by C-section. Larger babies are also at greater risk of childhood obesity.
  • Preterm labor. The higher your pre-pregnancy BMI and the more weight you gain during pregnancy, the more likely your baby is to be born prematurely. Preterm birth raises a baby's risk of a number of health issues depending on how premature the baby is, including breathing difficulties, eating challenges and, sometimes, developmental and learning problems later in life.
  • Obesity and ongoing health issues. If you gain too much weight, you may have a harder time losing it after your baby is born than you would if you'd been able to stay within the guidelines. What’s more, women who gain excessively and don't lose the extra weight in the six months to year after giving birth are at a higher risk of being overweight or even obese 10 years later, which comes with its own set of health challenges.

It is possible to get your weight gain under control with help from your doctor by modifying your diet and exercise routines. So don't beat yourself up if you're putting on too many pounds during your pregnancy. Just do what you can to get back on track as soon as possible.