An obese, 25-year-old G1P0 comes to your office at 8 weeks gestational age for her first prenatal visit. She is delighted to be pregnant and wants to do whatever is necessary to ensure a healthy pregnancy. She is currently 5 ft, 2 in. tall and weighs 300 lb. She is concerned because she is overweight and wants you to help her with a strict exercise and diet regimen so that she can be healthier during the pregnancy. During your counseling session with the patient, you advise her of all of the following except

Women who are markedly obese are at increased risk of developing complications during pregnancy. Obese women are more likely to develop diabetes and hypertension during pregnancy. In addition, these women are more likely to develop fetal macrosomia and undergo cesarean section for delivery. Morbidly obese women who do not gain weight during pregnancy are not at risk for having a fetus with growth abnormalities, and therefore they do not need to gain the 25 to 35 lb recommended for women of normal weight. Although it is not recommended that obese women gain weight during pregnancy, diet restriction and weight loss are to be avoided. In addition, as with all women, it is not recommended that obese women initiate a rigorous exercise program during pregnancy.