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Pregnancy after Roux-en-Y

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Hi everyone,

Today I saw a 35-year-old patient who is 2.5 years out of roux-en-y

gastric bypass surgery. She's 9 weeks pregnant with twins. Current

weight is 313 lbs (BMI 44.3)and total weight loss since surgery is 180

lbs. She admits that she is fearful of gaining a lot of weight since

she's carrying twins. I'm looking for information regarding minimally

required weight gain to maintain a safe pregnancy, as well as ballpark

kcal recommendations. If someone can add their expertise to this case,

I'd really appreciate it.

Thank you,

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