Summary of American College of Obstetricians and Gynecologists (ACOG)

Thursday, Feb 01, 2018

Committee Opinion on Weight Gain during Pregnancy


American College of Obstetricians and Gynecologists. Committee opinion no. 548: weight gain during pregnancy. Obstet Gynecol. 2013 Jan;121(1):210-2. Link to ACOG


Weight gain during pregnancy is closely related to the health of mothers and their infants. Latest guidelines by the Institute of Medicine (IOM) regarding gestational weight gain serve as a basis for clinic practice.


  • To achieve best pregnancy, healthcare providers who care for pregnant women should:
    • Determine a woman's body mass index (BMI) at the initial prenatal visit.
    • Counsel her regarding the importance of appropriate weight gain, nutrition, exercise and the need to limit excessive weight gain. 
  • IOM gestational weight gain guidelines (Table 1) provide a clinicians basis for daily practice.
  • For twin pregnancy, IOM recommends the below gestational weight gain:
    • Women of normal weight: 37-54 Ib
    • Overweight women: 31-50 Ib
    • Obese women: 25-42 Ib

Table 1. IOM Weight Gain Recommendations for Pregnancy

Pregpregnancy Weight Category BMI Recommended Range of Total Weight (lb) Recommended Rates of Weight Gain*
in the Second and Thrid Trimesters (Ib) (Mean Range [Ib/wk])
Underweight < 18.5 28-40 1 (1-1.3)
Normal Weight 18.5-24.9 25-35 1 (0.8-1)
Overweight 25-29.9 15-25 0.6 (0.5-0.7)
(includes all classes)
> 30 11-20 0.5 (0.4-0.6)

* Calculations assume a 1.1-4.4 Ib weight gain in the first trimester.


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