I am 5'4 and 169 pounds I'm 5 weeks pregnant. Is it possible to have a healthy pregnancy and either stay the same weight or lose weight?

BMI 29. Your BMI is 29 indicating that you are overweight (BMI > 30 is obese -> 174 lbs or more for you). You can gain up to 15-20 lbs during the *entire* pregnancy. You can also continue to exercise and maintain your weight as long as you are eating healthy, avoiding crazy diets etc. My simple recommendation - eat lots of vegetables (broccoli, celery, etc)