The Institute of Medicine (IOM)13 recommends weight gain of 25 to 35 lbs for normal-weight women (BMI 18.5 to 24.9); 15 to 25 lbs for women who are overweight (BMI 25 to 29.9); and 11 to 20 lbs for women who are obese (BMI ≥ 30). These recommendations, however, are not directed specifically to women with GDM. Some experts recommend weight gain of 0-7 lbs for obese women with GDM, citing data showing reduced risk of macrosomia at this level of weight gain.14