Leblanc ES, Smith NX, Vesco KK, et al. - Researchers sought to ascertain if gestational weight gain reduces and pregnancy outcomes improve in correlation with prepregnancy weight loss. Between May 2015 and October 2019, they conducted a pragmatic randomized clinical trial at Kaiser Permanente Northwest, an integrated health system including women aged 18-40 years with BMI ≥ 27 kg/m ² who were planning pregnancy within 2 years. They forwarded recruitment contacts to 27,665 health system members who met age and BMI criteria; 329 women attended screening visits and 326 were randomized. Among the 326 randomized participants, singleton pregnancies lasting ≥ 14 weeks were reported in 169 (analytic cohort: intervention n = 89, control n = 80). Women's likelihood of exceeding gestational weight gain guidelines did not differ by participation in the prepregnancy weight loss intervention. While successful weight loss was reported in the intervention group prior to conception, this group had greater weight gain in late pregnancy. They suggest combining prepregnancy weight loss interventions with intensive weight management that continues through delivery for effectively reducing weight throughout pregnancy and improving maternal and child outcomes,.