Most overweight/obese pregnant women gain more weight than they should during pregnancy, which can lead to adverse maternal and neonatal outcomes. This study evaluated the Maternal Lighten Up service, in which obese pregnant women are referred by their midwives to a choice of several weight-management programmes. Weight is measured at the start and self-reported at the end of pregnancy. Of women referred, only 36% started a programme. The Health Trainers programme was most popular and most frequently attended, followed by Slimming World. Participants attending Slimming World and dietetic programmes were less likely to exceed Institute of Medicine guidance on weight gain during pregnancy, but these data are based on low follow-up rates of weight at the end of pregnancy. This study provides insight into the preferences and behaviour of obese pregnant women referred to different weight management programmes, and the findings may contribute towards shaping future maternal obesity weight management services.