In a small 2007 study, Artal and his colleagues followed 96 obese pregnant women with gestational diabetes who either self-enrolled in a diet-and-exercise program designed to help them control their weight gain, or followed the diet typically prescribed to women with gestational diabetes.
The researchers found that women in either group who maintained or lost weight were less likely to have a larger-than-normal newborn. And there was no evidence that weight loss harmed fetal growth.
Artal, who was also the lead author on the American College of Obstetricians and Gynecologists current guidelines on exercise during pregnancy, contended that obese women “can safely maintain or even lose weight, under close medical supervision.”
Artal has been critical of the IOM recommendations that obese women gain 11 to 20 pounds during pregnancy, arguing that such weight gain not only raises the odds of pregnancy complications like pre-eclampsia, but also contributes to women’s lifetime weight problems and the associated health risks. Obese women commonly retain excess fat that they gain with each pregnancy.
In an article published earlier this year in the journal Obstetrics & Gynecology, Artal and colleagues at Yale University and Duke University also criticized the IOM guidelines for not considering the different classes of obesity when advising pregnant women on weight gain.
So with the messages on weight gain differing, what should obese pregnant women do?
Artal said his general advice is for women to eat a “nutrient-rich” diet — which would include plenty of fruits, vegetables, legumes and high-fiber grains — and to aim to take a 30-minute walk everyday as a form of low-impact physical activity.
He also advised all obese pregnant women to manage their weight only under the guidance of their obstetrician — if possible, one with experience in managing high-risk pregnancies.
Diet

Most pregnant women have a misconception of pregnancy as a period of indulgence. According to obstetrician-gynecologist Dr. Raul Artal, indulging on food high in calories such as sweets can pose a danger of pre-eclampsia, high blood pressure, or diabetes. “Eating for two" during pregnancy applies more to the amount of nutrients that a pregnant woman should consume rather than the amount of calories. Foods that are high in nutrients such as vegetables, fruits, nuts, lean meats and low-fat dairy products are more recommended. The top 5 nutrients that pregnant women actually need are calcium, folate, iron, protein, and vitamin C. Eating healthy can also decrease the feeling of tiredness and fatigue. Finally, avoid skipping meals during pregnancy. According to Dr. Laura Caufield, the risk of having premature labor increases among those who habitually skip meals. Eating breakfast is also important to avoid feeling lightheaded, famished, and sick to your stomach.