Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 20 1 2026 07 22 19 31 Elnaz Kalantari Department of Health Management, Policy, and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Maryam Tajvar Department of Health Management, Policy, and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Shohreh Naderimagham Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran AND Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Amirhossein Takian Department of Health Management, Policy, and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran AND Center of Excellence for Global Health, Department of Global Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran AND Health Equity Research Center, Tehran University of Medical Sciences, Tehran, Iran 2025 10 06 2026 06 03 Objective: Obesity is a global health threat, especially among women of reproductive age, and it adversely affects the health of both mothers and their children. This study aimed to identify and analyze the causes and management challenges of maternal obesity in Iran from the perspectives of key informants. Materials and methods: This is a qualitative study. We conducted semi-structured, in-depth interviews with 20 experts, from September to December 2023. We analyzed data using Leichter’s (1979) framework throught an inductive-deductive approach, facilitaed with MAXQDA 2020 software. Results: We identified challenges in managing maternal obesity and categorized them into 10 main categories and 21 sub-categories, grouped within five constructs according to Leichter’s framework: Situational factors (climate changes and international sanctions), Structural factors (high prevalence of overweight and obesity among women and unfavorable economic conditions), Socio-cultural factors (misconceptions and misuse of traditional Iranian medicine), Environmental or International factors (social norms and values, and the limited influence of international organizations), and Governance and Executive factors (weak governance by the Ministry of Health and Medical Education (MoHME) and poor inter-sectoral cooperation). Conclusion: Addressing maternal obesity is essential to achieve Sustainable Development Goals (SDGs), particularly in low- and middle-income countries (LMICs). Current challenges such as food insecurity, economic decline, and insufficient maternal awareness threaten maternal health in relation to obesity. Tackling these issues requires a coordinated, multi-sectoral approach involving healthcare system strengthening, public awareness campaigns, and empowerment of women and families. Prioritizing maternal obesity within national health agendas is critical for an effective response. Further research on maternal obesity in Iran is recommended to uncover root causes and develop effective interventions, providing policymakers with the evidence needed for informed decision-making. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/3512 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/3512/750