Patient description: A 57-year-old man was admitted to the clinic because of weight loss and persistent dry cough 4 months ago. Chest computed topography showed bilateral multiple infiltrates in the upper lobes and thickened bronchial walls. There is a documented positive serum MPO-ANCA in his medical record. Transbronchial biopsy revealed necrotic granulomas with multinucleated giant cells and the Wegener's granulomatosis was diagnosed for him. He is treating with corticosteroid and cyclophosphamides since 4 months ago. His Birmingham Vasculitis Activity Score (BVAS) is above 4 since the beginning of his disease. His last physical exam and lab study was performed yesterday and showed the results bellow: A wellbeing, well-nourished man, non-icteric, cooperative and alert Weight: 73 kg Height: 177 BP: 120/80 HR: 90/min RR: 22/min Hgb: 13 g/dl WBC: 8000 /mm3 (Neutrophil: 2700/mm3) Plt: 300000 /ml AST: 40 U/L ALT: 56 U/L Alk P: 147 U/L Bill total: 1.2 mg/dl ESR: 120 mm/hr MPO-ANCA: 153 EU

Clinical trial eligibility criteria: eligible ages (years): 18.0-40.0,  Obesity Lifestyle-related Condition Macrosomia, Fetal All subjects will have had by the time of randomization at 3 months postpartum: 1. Planning another pregnancy within the next 24 months 2. Planning to deliver at Tufts medical center during their next pregnancy 3. A previous full-term singleton pregnancy (gestational age > 37 weeks) 4. 18 to 40 years of age at the time of enrollment into the study 5. Vaginal or cesarean delivery 6. Normal glucose tolerance or gestational diabetes (GDM), but without evidence of postpartum diabetes as defined by a 75 g 2-hr oral glucose tolerance test (OGTT) 7. Normal blood pressure or mild preeclampsia but normal postpartum blood pressure 8. Bottle or breast feeding 9. Normal thyroid function (determined by TSH concentration in blood), normal cell blood count and normal kidney and liver functions. Lipid profile with triglyceride levels not higher than 400 mg/dl (fasting) and LDL levels less than 180 mg/dL 10. No clinical signs or symptoms of cardiovascular disease or any other disease or condition that may contraindicate participation in exercise training (i.e. COPD, severe asthma, orthopedic abnormalities) 11. Using contraception  Pre or post-delivery diabetes 2. Post-delivery hypertension requiring medication 3. asthma requiring more than occasional use of a sympathomimetic inhaler, but not chronic inhaled steroids 4. Inflammatory bowel disease 5. Need for assisted reproductive technologies to become pregnant 6. Medical or obstetrical contraindication to the defined exercise program or diet 7. Tobacco, excessive alcohol use (greater than 2 drinks/day) or illicit drug use 8. Eating disorders such as bulimia 9. Gastric surgery to lose weight including banding or bypass procedures 10. Any psychological or psychiatric condition which may impair participation in the lifestyle intervention program 11. Multiple pregnancy 12. HIV, or hepatitis B or C 13. If a LIPP subject becomes pregnant prior to 16 weeks after randomization before the weight loss phase for the lifestyle intervention is completed or a control subject becomes pregnant before the 3 month postpartum randomization, i.e. no baseline measurement