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To review the recently issued guidelines for weight gain during pregnancy.These guidelines were developed to minimize the negative health consequences for both mother and fetus of inadequate or excessive weight gain. They call for categorizing women's prepregnancy BMI using the WHO/National Heart, Lung and Blood Institute cutoff points and provide ranges of recommended weight gain for underweight (28–40 lb), normal weight (25–35 lb), overweight (15–25 lb) and obese (11–20 lb) gravidas. Data were insufficient to construct specific guidelines for women with class II or class III obesity. Women should attempt to conceive at a normal weight for better obstetric outcomes. Improved comprehensive preconceptional care is necessary to help women reach this goal. Most American women currently gain weight below or above the new ranges, so changes are required in both women's behavior and how their care is managed. Data from a variety of interventions related to improved diet and increased physical activity show that individualized care can assist women in gaining weight within these guidelines.The guidelines offer many opportunities for obstetrician/gynecologists, together with ancillary healthcare providers, to assume a larger role as ‘women's healthcare physicians' and to conduct research that could improve the health of mothers and children.