Overview

• A secondary analysis of the Lifestyle Interventions for Expectant Moms randomized trial was published in JAMA Network Open in August 2025.
• Among about 400 participants with obesity, gestational diabetes occurred in 24% with metabolically unhealthy profiles versus 10% with metabolically healthy profiles.
• The metabolically unhealthy group gained roughly 37% less weight during pregnancy yet had higher risks for both maternal and infant outcomes.
• Both groups received a lifestyle program starting near the end of the first trimester and showed similar responses, suggesting earlier, metabolism-focused strategies could be more effective.
• Metabolically healthy obesity was defined as obesity without major metabolic risk factors, while the unhealthy classification required at least two such factors, including elevated glucose, blood pressure or cholesterol.