On May 29, 2015 Dr. Zach Ferraro delivered grand rounds at Sunnybrook Hospital in Toronto. His presentation was titled “Are Health Canada’s pregnancy weight gain guidelines too liberal for patients with obesity?”. Currently, Health Canada’s guidelines for women with obesity are 5-9 kg at term. However, recent evidence suggests that these are in fact too liberal and that with advance stages of pre-pregnancy obesity (BMI>40) modest weight gain (0-5 kg) and at times pregnancy weight loss do not increase the risk of adverse maternal-fetal outcomes. It was a stimulating and well-attended presentation to a group of medical residents and staff physicians.