Body weight is an important consideration for both men and women before conception.

• Underweight: Being below a healthy weight can reduce fertility and increase the risk of preterm delivery.
• Overweight or obesity: Living with overweight or obesity can reduce fertility and increase pregnancy-related risks, including gestational diabetes, hypertension, macrosomia, caesarean delivery, and postpartum haemorrhage.

Promoting healthy behaviours – such as balanced nutrition and regular physical activity – will improve preconception health, even if weight loss or gain is not achieved. Ensuring key nutrients are consumed in adequate amounts throughout the day supports fertility and pregnancy outcomes.

It is important to recognise that body weight is influenced by multiple factors beyond diet and exercise, including food security, built environment, cultural context, work demands, and stress. Approaches to supporting healthy weight should be non-stigmatising and tailored to the individual’s circumstances.

Encourage patients to set achievable nutrition and physical activity goals to support overall health before pregnancy.

Recognise that weight loss or gain can be challenging and may take time. Emphasise the multiple health benefits of healthy eating and regular physical activity that often occur before weight changes, including:

• Improved sleep quality
• Increased energy levels
• Hormone regulation
• Stabilised blood sugar
• Better blood pressure

Making goals based on non-weight outcomes, such as those above, helps shift the focus from weight alone to overall health and wellbeing, making health behaviour improvements more sustainable and motivating.