Mobile App May Help Prevent Excess Weight Gain in Pregnancy
Key Takeaways:
- A digital intervention combining self-monitoring and personalised feedback helped reduce excess weight gain during pregnancy among women with overweight or obesity
- Participants using the programme gained weight more slowly and were less likely to exceed recommended guidelines compared with standard care
- Greater engagement, particularly consistent self-weighing, was linked to better outcomes
Addressing a common challenge in pregnancy
Weight gain during pregnancy is both expected and necessary. However, gaining more than recommended levels is associated with increased health risks for both the pregnant person and the baby. These risks are particularly pronounced among individuals who are already living with overweight or obesity at the start of pregnancy.
Excess gestational weight gain has been linked to complications such as gestational diabetes and preeclampsia. It also increases the likelihood of pre-term birth and larger birthweight, both of which can complicate delivery and raise the child’s long-term risk of obesity.
In the United States, around half of pregnant individuals with overweight or obesity exceed national guidelines for weight gain, highlighting a persistent challenge in routine prenatal care.
The LEAP programme – a technology-enabled approach
To address this issue, researchers at Kaiser Permanente developed the Lifestyle, Eating, and Activity in Pregnancy (LEAP) programme. The intervention was designed to provide scalable, technology-driven support integrated into everyday clinical care.
The study, published in JAMA Network Open on 20 April, evaluated whether this digital approach could help individuals maintain healthier weight gain trajectories during pregnancy.
“Our results are especially exciting because we intentionally designed the LEAP program to be feasible for widespread implementation,” said first author Monique Hedderson, PhD, principal investigator with the Kaiser Permanente Division of Research (DOR). “This study represents the culmination of years of research on what works well for this high-risk population and how to leverage technology to make those benefits achievable across a health system.”
How the intervention worked
Participants in the LEAP group were provided with a digital scale for home use and a wearable activity tracker, either a Fitbit or their own Apple Watch. These devices were connected to a mobile application that delivered automated, personalised feedback on both weight and physical activity.
The programme also included weekly educational sessions delivered through the app, focusing on realistic and achievable goals related to diet and exercise. In parallel, clinicians received guidance on how to discuss gestational weight gain with patients more effectively.
A key feature of the programme was its adaptive design. Individuals whose weight gain began to accelerate received targeted support, including personalised chat messages from a lifestyle coach. If necessary, this support escalated to telephone consultations.
“About half of patients in the LEAP intervention group managed weight well on their own, but for those inching towards the upper limit of recommendations, LEAP provided extra, targeted support,” said Hedderson. “This conserves resources for patients who need help the most.”
Study design and participant outcomes
The effectiveness of the LEAP programme was assessed across 58 clinicians within Kaiser Permanente Northern California. All pregnant patients with overweight or obesity under their care were invited to participate.
Clinicians were randomly assigned to one of two groups:
- Standard care plus the LEAP intervention
- Standard care alone
In total, 1,256 participants were included in the study. Of these, 677 received the LEAP programme, while 588 received standard care.
Standard care involved providing patients with a newsletter at their first prenatal visit outlining healthy weight gain targets and lifestyle advice. At around 20 weeks, clinicians reviewed weight gain against recommended guidelines.
The results showed clear differences between the groups. Participants in the LEAP programme experienced:
- Lower weekly rates of weight gain
- Lower total weight gain during pregnancy
- Reduced likelihood of exceeding recommended guidelines
In addition, fewer individuals in the LEAP group gave birth to infants classified as large for gestational age.
“This study demonstrates that combining wireless self-monitoring tools with an adaptive digital intervention can make a meaningful difference for patients with overweight or obesity at risk of excess weight gain during pregnancy,” said Kari Carlson, MD, director of women’s health for The Permanente Medical Group. “Importantly, it was tested in routine care, making the findings highly relevant for health systems looking for practical solutions.”
Engagement matters
Although all participants assigned to the LEAP group were included in the analysis, only around half actively engaged with the programme. This reflects real-world conditions, where not all individuals fully participate in digital health interventions.
However, among those who did engage, outcomes were notably stronger. Higher levels of interaction with the programme, particularly consistent self-weighing, were associated with lower overall weight gain.
“When we zoomed in on participants who actually engaged, we found that the more they engaged, especially by weighing themselves consistently, the less weight they gained,” Hedderson said.
Participants could view their weight trends in relation to Institute of Medicine guidelines within the app, a feature that appeared to play a particularly important role in supporting behaviour change.
“This seems to be a particularly effective component of the program,” she said.
Implications for clinical practice
The findings suggest that digital, scalable interventions such as LEAP could offer a practical solution to a longstanding challenge in prenatal care. By integrating self-monitoring tools, automated feedback, and targeted coaching into routine workflows, the programme demonstrates how technology can support both patients and clinicians without increasing burden.
“Excess gestational weight gain among these high-risk patients is a common and challenging issue in routine prenatal care,” said senior author Assiamira Ferrara, MD, PhD, a DOR senior research scientist. “What’s compelling about the LEAP study is that it shows we can support healthier weight gain using scalable, technology-enabled tools that fit within real-world clinical workflows, without adding burden for patients or clinicians.”
Looking ahead
The research team continues to follow participants to assess longer-term outcomes for both parents and children. There is optimism that the LEAP programme could be integrated into routine care in the near future.
“Bottom line, using technology to help patients manage their own health can be effective, and patients tend to like it, too,” Hedderson said.
Funding and research team
The study was funded by the National Institutes of Health.
Additional co-authors included Susan D. Brown, PhD; Charles P. Quesenberry, PhD; Fei Xu, MS; Emily Liu, MPH; Karen L. Li, MPH; Sneha B. Sridhar, MPH; Tali Sedgwick, RDN; Page Kissel, BA; and Hillary D. Serrato Bandera, BA, all from the Division of Research. Mibhali M. Bhalala, MD, contributed from Kaiser Permanente Northern California, and Cheryl Albright, PhD, MPH, contributed from the University of Hawaii at Manoa School of Nursing and Dental Hygiene.
About the Kaiser Permanente Division of Research
The Kaiser Permanente Division of Research conducts epidemiological and health services research aimed at improving health outcomes and healthcare delivery. With more than 720 staff and approximately 630 active research projects, the division focuses on understanding the determinants of illness and advancing the quality and cost-effectiveness of care.
Source: Kaiser Permanente Division of Research
