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The impact of the obesity epidemic on women of childbearing age has been of particular concern in recent years as a result of studies linking maternal weight status to long‐term adverse outcomes for obese mothers and their offspring. The US Institute of Medicine developed new gestational weight gain guidelines based on this literature that attempts to strike a balance between the known risks and benefits of weight gain during pregnancy. More studies that include large numbers of obese women, examine outcomes beyond the perinatal period, and identify safe and effective pregnancy weight gain interventions are needed before lower weight gain recommendations can be made for obese women.