Weight gain during pregnancy, relationships among body image, body weight standards, and attitudes toward weight gain were investigated. Weight gain recommendations, based on preconceptional weight status (PCWS) reflected current practices in prenatal care at Sentara Norfolk General Hospital, Norfolk, VA, and provided a basis on which to categorize weight gain as inadequate, appropriate, and excess. Women who experienced excess weight gain (EWG) were compared to those who experienced appropriate weight gain (AWG) or inadequate weight gain (IWG) to identify their characteristics. Of the 138 women studied, 54 experienced EWG. Weight gain recommendations for overweight women were similar to those for normal weight women, 20-25% PCW. Obese women who lost weight or gained less than 15 pounds were identified with the inadequate weight gain group.