Holistic Assessment of Obesity in Pregnancy: considering metabolic health
Main Article Content
Abstract
Obesity is the most common complication to pregnancy with 16% to 30% of women worldwide living with high weights. Obesity has been defined solely by body mass index (BMI) without consideration of individual metabolic health. Neither most research nor research-based perinatal management guidelines have distinguished between metabolically healthy individuals and those with obesity related diseases. Several international medical organizations now recommend holistic health assessments that include screening for metabolic disorders in addition to BMI measurement, along with care recommendations tailored to metabolic health or disease. This article reviews research that studied outcomes for pregnant individuals living with obesity, who were stratified by metabolic health or disease, and their pregnancy outcomes. Additionally, methods for holistic health assessment during pregnancy are reviewed along with management for preclinical and clinical obesity based on international guidelines.
Article Details
How to Cite
JEVITT, Cecilia M..
Holistic Assessment of Obesity in Pregnancy: considering metabolic health.
Medical Research Archives, [S.l.], v. 14, n. 2, feb. 2026.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/7256>. Date accessed: 02 mar. 2026.
doi: https://doi.org/10.18103/mra.v14i2.7256.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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6. Kent L, McGirr M, Eastwood KA. Global trends in prevalence of maternal overweight and obesity: A systematic review and meta-analysis of routinely collected data retrospective cohorts. Int J Popul Data Sci. 2024;9(2):2401.
7. Wharton S, Lau DCW, Vallis M, Sharma AM, Biertho L, Campbell-Scherer D, et al. Obesity in adults: a clinical practice guideline. Canadian Medical Association Journal. 2020;192(31):E875–E91.
8. Busetto L, Dicker D, Frühbeck G, Halford JCG, Sbraccia P, Yumuk V, et al. A new framework for the diagnosis, staging and management of obesity in adults. Nature Medicine. 2024;30(9):2395–9.
9. Garvey WT. American Association of Clinical Endocrinologists and American College of Endocrinology Comprehensive Clinical Practice Guidelines For Medical Care of Patients with Obesity. Endocrine practice.22(supplement 3):1–203.
10. Schmidt M, Schaefer-Graf UM. The German guideline "Obesity in pregnancy": comparison with the international approach. Arch Gynecol Obstet. 2024;309(5):1699–705.
11. American Medical Association. AMA Proceedings: Support Removal of BMI as a Standard Measure in Medicine. 2023.
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15. World Health Organization. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. 1995;854:1–452.
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17. Zembic A, Eckel N, Stefan N, Baudry J, Schulze MB. An Empirically Derived Definition of Metabolically Healthy Obesity Based on Risk of Cardiovascular and Total Mortality. JAMA Network Open. 2021;4 (5):e218505.
18. Padwal RS, Pajewski NM, Allison DB, Sharma AM. Using the Edmonton obesity staging system to predict mortality in a population-representative cohort of people with overweight and obesity. Canadian Medical Association Journal. 2011;183 (14):E1059–E66.
19. Demsky AN, Stafford SM, Birch D, Sharma AM, Schulz JA, Steed H. The Edmonton Obesity Staging System Predicts Mode of Delivery After Labour Induction. Journal of Obstetrics and Gynaecology Canada. 2020;42(3):284–92.
20. Rubino F, Cummings DE, Eckel RH, Cohen RV, Wilding JPH, Brown WA, et al. Definition and diagnostic criteria of clinical obesity. The Lancet Diabetes & Endocrinology. 2025;13(3):221–62.
21. Santos AL, Sinha S. Obesity and aging: Molecular mechanisms and therapeutic approaches. Ageing Res Rev. 2021;67:101268.
22. Daemers D, Wijnen H, Van Limbeek E, Budé L, Nieuwenhuijze M, Spaanderman M, et al. The impact of obesity on outcomes of midwife‐led pregnancy and childbirth in a primary care population: a prospective cohort study. BJOG: An International Journal of Obstetrics & Gynaecology. 2014;121 (11):1403–14.
23. Hollowell J, Pillas D, Rowe R, Linsell L, Knight M, Brocklehurst P. The impact of maternal obesity on intrapartum outcomes in otherwise low risk women: secondary analysis of the Birthplace national prospective cohort study. BJOG: An International Journal of Obstetrics & Gynaecology. 2014;121(3):343–55.
24. Jevitt CM, Stapleton S, Deng Y, Song X, Wang K, Jolles DR. Birth Outcomes of Women with Obesity Enrolled for Care at Freestanding Birth Centers in the United States. Journal of Midwifery & Women's Health. 2021;66(1):14–23.
25. Pétursdóttir Maack H, Larsson A, Axelsson O, Olovsson M, Wikström AK, Sundström Poromaa I. Pregnancy in metabolic healthy and unhealthy obese women. Acta Obstetricia et Gynecologica Scandinavica. 2020;99(12):1640–8.
26. Relph S, Guo Y, Harvey ALJ, Vieira MC, Corsi DJ, Gaudet LM, et al. Characteristics associated with uncomplicated pregnancies in women with obesity: a population-based cohort study. BMC Pregnancy and Childbirth. 2021;21(1).
27. Rowe R, Knight M, Kurinczuk JJ. Outcomes for women with BMI > 35kg/m2 admitted for labour care to alongside midwifery units in the UK: A national prospective cohort study using the UK Midwifery Study System (UKMidSS). PLOS ONE. 2018;13(12): e0208041.
28. Vieira MC, White SL, Patel N, Seed PT, Briley AL, Sandall J, et al. Prediction of uncomplicated pregnancies in obese women: a prospective multicentre study. BMC Medicine. 2017;15(1).
29. Relph S, Ong M, Vieira MC, Pasupathy D, Sandall J. Perceptions of risk and influences of choice in pregnant women with obesity. An evidence synthesis of qualitative research. PLOS ONE. 2020; 15(1):e0227325.
30. Jevitt CM. Obesity and Socioeconomic Disparities: Rethinking Causes and Perinatal Care. J Perinat Neonatal Nurs. 2019;33(2):126–35.
31. World Health Organization. WHO Constitution. 2025.
32. Gaudet-Blavignac C, Rudaz A, Lovis C. Building a Shared, Scalable, and Sustainable Source for the Problem-Oriented Medical Record: Developmental Study. JMIR Medical Informatics. 2021;9(10):e29174.
33. Jevitt CM, Ketchum K. Pairing Evidence-Based Strategies With Motivational Interviewing to Support Optimal Nutrition and Weight Gain in Pregnancy. J Perinat Neonatal Nurs. 2024;38(1): 25–36.
34. Christenson A, Johansson E, Reynisdottir S, Torgerson J, Hemmingsson E. Shame and avoidance as barriers in midwives' communication about body weight with pregnant women: A qualitative interview study. Midwifery. 2018;63:1–7.
35. Christenson A, Johansson E, Reynisdottir S, Torgerson J, Hemmingsson E. "…or else I close my ears" How women with obesity want to be approached and treated regarding gestational weight management: A qualitative interview study. PLOS ONE. 2019;14(9):e0222543.
36. Harinath M, Smith AM, Binstock AB, Pollak KI, Levine MD, Chang JC. Starting Conversations About Gestational Weight Gain: How Weight and Weight Gain Communication Is Initiated in the First Prenatal Visit [ID 2683652]. Obstetrics & Gynecology. 2024;143(5S):64S–5S.
37. Raju S, Cowdell PF, Dyson PJ. Midwives' experiences of supporting healthy gestational weight management: A mixed methods systematic literature review. Midwifery. 2023;124:103750.
38. Fisher SA, Kominiarek MA. Gestational Weight Gain in Pregnant People with Obesity. Current Obstetrics and Gynecology Reports. 2023;12(1): 17–29.
39. Kominiarek MA, Seligman NS, Dolin C, Gao W, Berghella V, Hoffman M, et al. Gestational weight gain and obesity: is 20 pounds too much? American Journal of Obstetrics and Gynecology. 2013;209 (3):214.e1–.e11.
40. Grandfils S, Durand P, Hoge A, Seidel L, Emonts P, Paquot N, et al. Gestational weight gain: Toward best practices in managing gestational weight gain in patients with obesity: Comparison of recommendations. Eur J Obstet Gynecol Reprod Biol. 2024;298:197–203.
41. Aoyama T, Li D, Bay JL. Weight Gain and Nutrition during Pregnancy: An Analysis of Clinical Practice Guidelines in the Asia-Pacific Region. Nutrients. 2022;14(6):1288.
42. Daida Y, Pedula K. Prevalence of Overweight and Obese Prepregnancy BMI and Excessive Gestational Weight Gain Using Asian-Specific Cutoffs Among Asian and Mixed-Asian Women Living in Hawaii: A Retrospective Cohort Study. Maternal and Child Health Journal. 2023;27(4):728–36.
43. Morisaki N, Nagata C, Jwa SC, Sago H, Saito S, Oken E, et al. Pre-pregnancy BMI-specific optimal gestational weight gain for women in Japan. J Epidemiol. 2017;27(10):492–8.
44. Zhang C-X, Lai J-Q, Liu K-Y, Yang N-H, Zeng G, Mao L-M, et al. Optimal gestational weight gain in Chinese pregnant women by Chinese-specific BMI categories: a multicentre prospective cohort study. Public Health Nutrition. 2021;24(11):3210–20.
45. Hasted T, Stapleton H, Beckmann MM, Wilkinson SA. Clinician's Attitudes to the Introduction of Routine Weighing in Pregnancy. Journal of Pregnancy. 2016;2016:1–9.
46. Dimperio DL, Frentzen BH, Cruz AC. Routine weighing during antenatal visits. BMJ. 1992;304 (6825):460.
47. Aoyama T, Li D, Bay JL. Weight Gain and Nutrition during Pregnancy: An Analysis of Clinical Practice Guidelines in the Asia-Pacific Region. Nutrients. 2022;14(6).
48. Abrams B, Altman SL, Pickett KE. Pregnancy weight gain: still controversial. Am J Clin Nutr. 2000;71(5 Suppl):1233s–41s.
49. Dawes MG, Grudzinskas JG. Repeated measurement of maternal weight during pregnancy. Is this a useful practice? BJOG: An International Journal of Obstetrics & Gynaecology. 1991;98(2): 189–94.
50. Daley A, Jolly K, Jebb S, Lewis A, Clifford S, Roalfe A, et al. Feasibility and acceptability of regular weighing, setting weight gain limits and providing feedback by community midwives to prevent excess weight gain during pregnancy: randomised controlled trial and qualitative study. BMC Obesity. 2015;2(1).
51. Auckburally S, Davies E, Logue J. The Use of Effective Language and Communication in the Management of Obesity: the Challenge for Healthcare Professionals. Current Obesity Reports. 2021;10(3):274–81.
52. Bowman-Busato J, Schreurs L, Halford JCG, Yumuk V, O'Malley G, Woodward E, et al. Providing a common language for obesity: the European Association for the Study of Obesity obesity taxonomy. International Journal of Obesity. 2025;49(2):182–91.
53. Brown A, Flint SW. Preferences and emotional response to weight‐related terminology used by healthcare professionals to describe body weight in people living with overweight and obesity. Clinical Obesity. 2021;11(5).
54. Puhl RM. What words should we use to talk about weight? A systematic review of quantitative and qualitative studies examining preferences for weight-related terminology. Obes Rev. 2020;21(6):e13008.
55. Kominiarek MA, Peaceman AM. Gestational weight gain. American Journal of Obstetrics and Gynecology. 2017;217(6):642–51.
56. Zafar MI, Mills KE, Zheng J, Peng MM, Ye X, Chen LL. Low glycaemic index diets as an intervention for obesity: a systematic review and meta‐analysis. Obesity Reviews. 2019;20(2):290–315.
57. Mijatovic-Vukas J, Capling L, Cheng S, Stamatakis E, Louie J, Cheung NW, et al. Associations of Diet and Physical Activity with Risk for Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis. Nutrients. 2018;10(6):698.
58. Teede HJ, Bailey C, Moran LJ, Bahri Khomami M, Enticott J, Ranasinha S, et al. Association of Antenatal Diet and Physical Activity–Based Interventions With Gestational Weight Gain and Pregnancy Outcomes. JAMA Internal Medicine. 2022;182(2):106.
59. Brady EM, Bodicoat DH, Hall AP, Khunti K, Yates T, Edwardson C, et al. Sleep duration, obesity and insulin resistance in a multi-ethnic UK population at high risk of diabetes. Diabetes Res Clin Pract. 2018;139:195–202.
60. Capers PL, Fobian AD, Kaiser KA, Borah R, Allison DB. A systematic review and meta-analysis of randomized controlled trials of the impact of sleep duration on adiposity and components of energy balance. Obes Rev. 2015;16(9):771–82.
61. Itani O, Jike M, Watanabe N, Kaneita Y. Short sleep duration and health outcomes: a systematic review, meta-analysis, and meta-regression. Sleep Med. 2017;32:246–56.
62. U.S. Centers for Disease Control. QuickStats: Percentage of Employed Adults Aged ≥18 Years Who Slept ≤ 7 Hours per 24-Hour Period, by Sex and Number of Work Hours per Week-United States, 2022. MMWR Morbidity and Mortality Weekly Report. 2024;73(16):385.
2. Maxwell C, Gaudet L, Cassir G, Nowik C, McLeod NL, Jacob CE, et al. Guideline No. 391-Pregnancy and Maternal Obesity Part 1: Pre-conception and Prenatal Care. J Obstet Gynaecol Can. 2019;41(11):1623–40.
3. Maxwell C, Gaudet L, Cassir G, Nowik C, McLeod NL, Jacob CE, et al. Guideline No. 392-Pregnancy and Maternal Obesity Part 2: Team Planning for Delivery and Postpartum Care. J Obstet Gynaecol Can. 2019;41(11):1660–75.
4. Ferris L, de Vries B, Sweeting A. Management of obesity in pregnancy. Aust N Z J Obstet Gynaecol. 2022;62(5):623–5.
5. Sagi-Dain L. Obesity in Pregnancy: ACOG Practice Bulletin, Number 230. Obstet Gynecol. 2021;138(3):489.
6. Kent L, McGirr M, Eastwood KA. Global trends in prevalence of maternal overweight and obesity: A systematic review and meta-analysis of routinely collected data retrospective cohorts. Int J Popul Data Sci. 2024;9(2):2401.
7. Wharton S, Lau DCW, Vallis M, Sharma AM, Biertho L, Campbell-Scherer D, et al. Obesity in adults: a clinical practice guideline. Canadian Medical Association Journal. 2020;192(31):E875–E91.
8. Busetto L, Dicker D, Frühbeck G, Halford JCG, Sbraccia P, Yumuk V, et al. A new framework for the diagnosis, staging and management of obesity in adults. Nature Medicine. 2024;30(9):2395–9.
9. Garvey WT. American Association of Clinical Endocrinologists and American College of Endocrinology Comprehensive Clinical Practice Guidelines For Medical Care of Patients with Obesity. Endocrine practice.22(supplement 3):1–203.
10. Schmidt M, Schaefer-Graf UM. The German guideline "Obesity in pregnancy": comparison with the international approach. Arch Gynecol Obstet. 2024;309(5):1699–705.
11. American Medical Association. AMA Proceedings: Support Removal of BMI as a Standard Measure in Medicine. 2023.
12. Institute of Medicine, National Research Council Committee to Reexamine Weight Gain During Pregnancy. The National Academies Collection: Reports funded by National Institutes of Health. In: Rasmussen KM, Yaktine AL, editors. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington (DC): National Academies Press (US) Copyright © 2009, National Academy of Sciences.; 2009.
13. Kominiarek MA, Chauhan SP. Obesity Before, During, and After Pregnancy: A Review and Comparison of Five National Guidelines. Am J Perinatol. 2016;33(5):433–41.
14. De Lorenzo A, Gratteri S, Gualtieri P, Cammarano A, Bertucci P, Di Renzo L. Why primary obesity is a disease? Journal of Translational Medicine. 2019; 17(1).
15. World Health Organization. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. 1995;854:1–452.
16. Olson SM, Muñoz EG, Solis EC, Bradford HM. Mitigating Weight Bias in the Clinical Setting: A New Approach to Care. Journal of Midwifery & Women's Health. 2024;69(2):180–90.
17. Zembic A, Eckel N, Stefan N, Baudry J, Schulze MB. An Empirically Derived Definition of Metabolically Healthy Obesity Based on Risk of Cardiovascular and Total Mortality. JAMA Network Open. 2021;4 (5):e218505.
18. Padwal RS, Pajewski NM, Allison DB, Sharma AM. Using the Edmonton obesity staging system to predict mortality in a population-representative cohort of people with overweight and obesity. Canadian Medical Association Journal. 2011;183 (14):E1059–E66.
19. Demsky AN, Stafford SM, Birch D, Sharma AM, Schulz JA, Steed H. The Edmonton Obesity Staging System Predicts Mode of Delivery After Labour Induction. Journal of Obstetrics and Gynaecology Canada. 2020;42(3):284–92.
20. Rubino F, Cummings DE, Eckel RH, Cohen RV, Wilding JPH, Brown WA, et al. Definition and diagnostic criteria of clinical obesity. The Lancet Diabetes & Endocrinology. 2025;13(3):221–62.
21. Santos AL, Sinha S. Obesity and aging: Molecular mechanisms and therapeutic approaches. Ageing Res Rev. 2021;67:101268.
22. Daemers D, Wijnen H, Van Limbeek E, Budé L, Nieuwenhuijze M, Spaanderman M, et al. The impact of obesity on outcomes of midwife‐led pregnancy and childbirth in a primary care population: a prospective cohort study. BJOG: An International Journal of Obstetrics & Gynaecology. 2014;121 (11):1403–14.
23. Hollowell J, Pillas D, Rowe R, Linsell L, Knight M, Brocklehurst P. The impact of maternal obesity on intrapartum outcomes in otherwise low risk women: secondary analysis of the Birthplace national prospective cohort study. BJOG: An International Journal of Obstetrics & Gynaecology. 2014;121(3):343–55.
24. Jevitt CM, Stapleton S, Deng Y, Song X, Wang K, Jolles DR. Birth Outcomes of Women with Obesity Enrolled for Care at Freestanding Birth Centers in the United States. Journal of Midwifery & Women's Health. 2021;66(1):14–23.
25. Pétursdóttir Maack H, Larsson A, Axelsson O, Olovsson M, Wikström AK, Sundström Poromaa I. Pregnancy in metabolic healthy and unhealthy obese women. Acta Obstetricia et Gynecologica Scandinavica. 2020;99(12):1640–8.
26. Relph S, Guo Y, Harvey ALJ, Vieira MC, Corsi DJ, Gaudet LM, et al. Characteristics associated with uncomplicated pregnancies in women with obesity: a population-based cohort study. BMC Pregnancy and Childbirth. 2021;21(1).
27. Rowe R, Knight M, Kurinczuk JJ. Outcomes for women with BMI > 35kg/m2 admitted for labour care to alongside midwifery units in the UK: A national prospective cohort study using the UK Midwifery Study System (UKMidSS). PLOS ONE. 2018;13(12): e0208041.
28. Vieira MC, White SL, Patel N, Seed PT, Briley AL, Sandall J, et al. Prediction of uncomplicated pregnancies in obese women: a prospective multicentre study. BMC Medicine. 2017;15(1).
29. Relph S, Ong M, Vieira MC, Pasupathy D, Sandall J. Perceptions of risk and influences of choice in pregnant women with obesity. An evidence synthesis of qualitative research. PLOS ONE. 2020; 15(1):e0227325.
30. Jevitt CM. Obesity and Socioeconomic Disparities: Rethinking Causes and Perinatal Care. J Perinat Neonatal Nurs. 2019;33(2):126–35.
31. World Health Organization. WHO Constitution. 2025.
32. Gaudet-Blavignac C, Rudaz A, Lovis C. Building a Shared, Scalable, and Sustainable Source for the Problem-Oriented Medical Record: Developmental Study. JMIR Medical Informatics. 2021;9(10):e29174.
33. Jevitt CM, Ketchum K. Pairing Evidence-Based Strategies With Motivational Interviewing to Support Optimal Nutrition and Weight Gain in Pregnancy. J Perinat Neonatal Nurs. 2024;38(1): 25–36.
34. Christenson A, Johansson E, Reynisdottir S, Torgerson J, Hemmingsson E. Shame and avoidance as barriers in midwives' communication about body weight with pregnant women: A qualitative interview study. Midwifery. 2018;63:1–7.
35. Christenson A, Johansson E, Reynisdottir S, Torgerson J, Hemmingsson E. "…or else I close my ears" How women with obesity want to be approached and treated regarding gestational weight management: A qualitative interview study. PLOS ONE. 2019;14(9):e0222543.
36. Harinath M, Smith AM, Binstock AB, Pollak KI, Levine MD, Chang JC. Starting Conversations About Gestational Weight Gain: How Weight and Weight Gain Communication Is Initiated in the First Prenatal Visit [ID 2683652]. Obstetrics & Gynecology. 2024;143(5S):64S–5S.
37. Raju S, Cowdell PF, Dyson PJ. Midwives' experiences of supporting healthy gestational weight management: A mixed methods systematic literature review. Midwifery. 2023;124:103750.
38. Fisher SA, Kominiarek MA. Gestational Weight Gain in Pregnant People with Obesity. Current Obstetrics and Gynecology Reports. 2023;12(1): 17–29.
39. Kominiarek MA, Seligman NS, Dolin C, Gao W, Berghella V, Hoffman M, et al. Gestational weight gain and obesity: is 20 pounds too much? American Journal of Obstetrics and Gynecology. 2013;209 (3):214.e1–.e11.
40. Grandfils S, Durand P, Hoge A, Seidel L, Emonts P, Paquot N, et al. Gestational weight gain: Toward best practices in managing gestational weight gain in patients with obesity: Comparison of recommendations. Eur J Obstet Gynecol Reprod Biol. 2024;298:197–203.
41. Aoyama T, Li D, Bay JL. Weight Gain and Nutrition during Pregnancy: An Analysis of Clinical Practice Guidelines in the Asia-Pacific Region. Nutrients. 2022;14(6):1288.
42. Daida Y, Pedula K. Prevalence of Overweight and Obese Prepregnancy BMI and Excessive Gestational Weight Gain Using Asian-Specific Cutoffs Among Asian and Mixed-Asian Women Living in Hawaii: A Retrospective Cohort Study. Maternal and Child Health Journal. 2023;27(4):728–36.
43. Morisaki N, Nagata C, Jwa SC, Sago H, Saito S, Oken E, et al. Pre-pregnancy BMI-specific optimal gestational weight gain for women in Japan. J Epidemiol. 2017;27(10):492–8.
44. Zhang C-X, Lai J-Q, Liu K-Y, Yang N-H, Zeng G, Mao L-M, et al. Optimal gestational weight gain in Chinese pregnant women by Chinese-specific BMI categories: a multicentre prospective cohort study. Public Health Nutrition. 2021;24(11):3210–20.
45. Hasted T, Stapleton H, Beckmann MM, Wilkinson SA. Clinician's Attitudes to the Introduction of Routine Weighing in Pregnancy. Journal of Pregnancy. 2016;2016:1–9.
46. Dimperio DL, Frentzen BH, Cruz AC. Routine weighing during antenatal visits. BMJ. 1992;304 (6825):460.
47. Aoyama T, Li D, Bay JL. Weight Gain and Nutrition during Pregnancy: An Analysis of Clinical Practice Guidelines in the Asia-Pacific Region. Nutrients. 2022;14(6).
48. Abrams B, Altman SL, Pickett KE. Pregnancy weight gain: still controversial. Am J Clin Nutr. 2000;71(5 Suppl):1233s–41s.
49. Dawes MG, Grudzinskas JG. Repeated measurement of maternal weight during pregnancy. Is this a useful practice? BJOG: An International Journal of Obstetrics & Gynaecology. 1991;98(2): 189–94.
50. Daley A, Jolly K, Jebb S, Lewis A, Clifford S, Roalfe A, et al. Feasibility and acceptability of regular weighing, setting weight gain limits and providing feedback by community midwives to prevent excess weight gain during pregnancy: randomised controlled trial and qualitative study. BMC Obesity. 2015;2(1).
51. Auckburally S, Davies E, Logue J. The Use of Effective Language and Communication in the Management of Obesity: the Challenge for Healthcare Professionals. Current Obesity Reports. 2021;10(3):274–81.
52. Bowman-Busato J, Schreurs L, Halford JCG, Yumuk V, O'Malley G, Woodward E, et al. Providing a common language for obesity: the European Association for the Study of Obesity obesity taxonomy. International Journal of Obesity. 2025;49(2):182–91.
53. Brown A, Flint SW. Preferences and emotional response to weight‐related terminology used by healthcare professionals to describe body weight in people living with overweight and obesity. Clinical Obesity. 2021;11(5).
54. Puhl RM. What words should we use to talk about weight? A systematic review of quantitative and qualitative studies examining preferences for weight-related terminology. Obes Rev. 2020;21(6):e13008.
55. Kominiarek MA, Peaceman AM. Gestational weight gain. American Journal of Obstetrics and Gynecology. 2017;217(6):642–51.
56. Zafar MI, Mills KE, Zheng J, Peng MM, Ye X, Chen LL. Low glycaemic index diets as an intervention for obesity: a systematic review and meta‐analysis. Obesity Reviews. 2019;20(2):290–315.
57. Mijatovic-Vukas J, Capling L, Cheng S, Stamatakis E, Louie J, Cheung NW, et al. Associations of Diet and Physical Activity with Risk for Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis. Nutrients. 2018;10(6):698.
58. Teede HJ, Bailey C, Moran LJ, Bahri Khomami M, Enticott J, Ranasinha S, et al. Association of Antenatal Diet and Physical Activity–Based Interventions With Gestational Weight Gain and Pregnancy Outcomes. JAMA Internal Medicine. 2022;182(2):106.
59. Brady EM, Bodicoat DH, Hall AP, Khunti K, Yates T, Edwardson C, et al. Sleep duration, obesity and insulin resistance in a multi-ethnic UK population at high risk of diabetes. Diabetes Res Clin Pract. 2018;139:195–202.
60. Capers PL, Fobian AD, Kaiser KA, Borah R, Allison DB. A systematic review and meta-analysis of randomized controlled trials of the impact of sleep duration on adiposity and components of energy balance. Obes Rev. 2015;16(9):771–82.
61. Itani O, Jike M, Watanabe N, Kaneita Y. Short sleep duration and health outcomes: a systematic review, meta-analysis, and meta-regression. Sleep Med. 2017;32:246–56.
62. U.S. Centers for Disease Control. QuickStats: Percentage of Employed Adults Aged ≥18 Years Who Slept ≤ 7 Hours per 24-Hour Period, by Sex and Number of Work Hours per Week-United States, 2022. MMWR Morbidity and Mortality Weekly Report. 2024;73(16):385.