It's not just "gaining too much" that's a concern; "gaining too little" is also a risk ─ New Insights on Pregnancy Weight

Two-thirds are "gaining too much" or "not gaining enough" ── To prevent pregnancy weight gain from becoming a "self-responsibility number" (including reactions from social media)

"Don't gain too much weight during pregnancy"

When told this during a health check-up, pressure often comes before relief... Such voices are not uncommon. However, a large-scale study introduced by the French medical site VIDAL reveals that it is actually the minority of pregnant women who fall within the recommended range. Based on an APMnews distribution (dated November 20, 2025), VIDAL's article reports the shocking result that only 32% of women gained weight as recommended during pregnancy, while 68% gained too much or too little.VIDAL

Using this article as a starting point, we will break down the study's content and consider how to untangle the structure where "weight gain = effort score," incorporating visible reactions from social media (including open posts on platforms like note).

1) Study Framework: A "modern" meta-analysis summarizing 40 studies and about 1.6 million people

The study introduced by VIDAL is a systematic review and meta-analysis led by Monash University, integrating 40 observational studies from 2009 to 2024, totaling about 1.6 million people (1,608,711 individuals).VIDAL

The study covers five of the six regions defined by WHO, although it notes biases such as the absence of studies from the African region.VIDAL

The most striking aspect is the distribution of weight gain.

• Within the recommended range: 32%

• Below the recommended range: 23%

• Above the recommended range: 45%

In other words, about two out of three people (68%) are "gaining too much" or "not enough.".VIDAL

These numbers do not suggest that "many pregnant women are unable to manage themselves," but rather highlight the possibility that **"the recommended values themselves may not adequately explain the diverse pregnancies of today."**

2) Both "gaining too much" and "not gaining enough" carry different risks

The VIDAL article organizes the point that risks to the mother and newborn increase in different ways when weight gain is below or above the recommended range.VIDAL

In cases of **below the recommended range (not gaining enough)**, notable risks include:

• Lower birth weight (average -185g)

• Increased risks of preterm birth, SGA (small for gestational age), low birth weight, respiratory distress, etc.
  On the other hand, risks of cesarean section and large for gestational age (LGA/macrosomia) tend to decrease.VIDAL

Conversely, in cases of **above the recommended range (gaining too much)**:

• Higher birth weight (average +118g)

• Increased risks of cesarean section, pregnancy-related hypertension, LGA/macrosomia, NICU admission, etc.
  On the other hand, risks of preterm birth and SGA tend to decrease.VIDAL

What this indicates is that pregnancy weight is not about "the less, the better" or "gaining is bad," but rather that **"either extreme can lead to different disadvantages."** Weight gain includes not only the baby's weight but also changes in blood volume, body fluids, placenta, etc., making it a "total value" that is difficult to judge solely by numbers.VIDAL

3) The issue of "Whose standards were those recommendations based on?"

The guidelines for pregnancy weight gain referenced in many countries are those by the US IOM (now NAM).National Academies

VIDAL emphasizes that these recommendations are based on data from "primarily white women" in high-income countries from the 1980s, raising concerns that they do not adequately reflect modern ethnic diversity and changes in dietary environments.VIDAL

In response, WHO established a **Technical Advisory Group (TAG-GWG) in 2023 to create global standards (standard values and optimal ranges) for pregnancy weight gain (GWG)..World Health Organization

Thus, this study is more about gathering materials to update "world standards" rather than competing over the "correctness of individual guidance."**World Health Organization

4) Caution when viewed through "Asian BMI standards"

The VIDAL article also touches on analysis using **Asian-specific BMI cut-offs (overweight at 23, obesity at 25, etc.)** in addition to WHO's BMI classifications.VIDAL

The conclusions are generally in the same direction, but it also notes the possibility that weight gain below the recommended range is associated with pregnancy-induced hypertension, as indicated by higher odds ratios.VIDAL

In the context of Japan, this area is prone to intertwining with body size (small stature, low BMI) and cultural "thinness orientation." If this is misread as "it's correct not to gain weight," the risks in the opposite direction become less visible.

5) Linked Editorial: Don't make "numerical goals" a "punishment game"

In the latter half of the VIDAL article, an important proposal from an editorial linked to the study is introduced. The gist is as follows.

• The idea of enforcing fixed thresholds (e.g., an upper limit of ◯kg) tends to ignore the biological and social diversity of pregnancy.

• What is important is not whether one has "exceeded/not exceeded" but rather the pattern of weight gain, background factors, and individualized, non-punitive support.VIDAL

This editorial takes the stance that support should be provided "across the life course (from pre-pregnancy to pregnancy to postpartum)," as explicitly stated with a DOI in the official BMJ release.BMJ Group

6) Visible Reaction Patterns on Social Media (Open Posts)

There was not a significant amount of reaction to the VIDAL article itself on Japanese social media as public information. Therefore, this time, we will organize the reaction patterns that repeatedly appear in open posts on platforms like note regarding the same theme (pregnancy weight, pressure of guidance, fear) (with limitations on the veracity and generalization of individual posts).

Reaction A: "I'm afraid to step on the scale" — Numbers erode mental health

There are many voices saying that weight measurement during pregnancy becomes more of a "report card" than health management. Some posts are written starting from the anxiety of "I'm afraid to step on the scale" or "What if I get scolded?"note

The necessity of "non-punitive support" as mentioned in the editorial precisely addresses this issue.VIDAL

Reaction B: "It used to be stricter" — Memories of the "culture" of guidance

There are also past experiences shared where being told "You're gaining too much weight" was a daily occurrence.note
While it is said that the atmosphere of guidance is changing in Japan, there may be regional and facility differences in experiences, and updates may not be uniformly reaching everyone.

Reaction C: "Uncontrollable due to nausea/vomiting" — The reality of life

Posts also describe how "nausea leads to weight gain" or "weight increases rapidly in the later stages," indicating that "the same effort can lead to different results" depending on the course of pregnancy. For example, cases where individuals struggle with weight gain in the later stages and document their experiences of being cautioned during check-ups.note

This is also an example showing that viewing "amount of gain