Exploring body dissatisfaction in pregnancy and the association with gestational weight gain, obesity, and weight stigma

Isabelle F Hill; Kirina Angrish; Sarah Nutter; Ximena Ramos-Salas; Harneet Minhas; Taniya S Nagpal

doi:10.1016/j.midw.2023.103627

Exploring body dissatisfaction in pregnancy and the association with gestational weight gain, obesity, and weight stigma

Midwifery. 2023 Apr:119:103627. doi: 10.1016/j.midw.2023.103627. Epub 2023 Feb 13.

Authors

Isabelle F Hill¹, Kirina Angrish¹, Sarah Nutter², Ximena Ramos-Salas³, Harneet Minhas¹, Taniya S Nagpal⁴

Affiliations

¹ Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, ON, Canada.
² Department of Educational Psychology and Leadership Studies, University of Victoria, BC, Canada.
³ Obesity Canada, Edmonton, AB, Canada.
⁴ Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, ON, Canada; Faculty of Kinesiology, Sport and Recreation, University of Alberta, AB, Canada. Electronic address: tnagpal@ualberta.ca.

PMID: 36804829
DOI: 10.1016/j.midw.2023.103627

Abstract

Objective: Body dissatisfaction in pregnancy has been associated with negative psychological maternal outcomes, including increased risk of postpartum depression. This study aimed to explore weight-related factors that influence body dissatisfaction in pregnancy, including gestational weight gain (GWG), weight stigma, obesity, and weight loss attempts before pregnancy.

Design: Secondary analysis of a larger cross-sectional study.

Setting: Online survey administered via Qualtrics.

Participants: ≥12 weeks pregnant, ≥18 years of age, having a singleton pregnancy and residing in Canada.

Measurements and findings: A battery of questionnaires were completed, including the Body Image in Pregnancy Scale (BIPS) sub-scale. The BIPS scores were compared based on experiences of weight stigma in pregnancy, perception towards their GWG, weight loss attempts before pregnancy, obesity, and GWG category classified as excessive or not referring to Institute of Medicine (2009) guidelines. Significant differences were entered into a linear regression model with BIPS scores as the dependent variable. Significance was accepted as p<0.05. A total of 182 participants completed the survey. There were no differences in BIPS scores based on GWG category (p = 0.160), or obesity (p = 0.230). Poorer BIPS scores were reported by those who felt they had gained 'too much' pregnancy weight than 'appropriate' (p<0.001), and among those who were trying to lose weight before pregnancy compared to those who were not (p = 0.002). Poorer BIPS scores were also reported by individuals who indicated they had experienced weight stigma during pregnancy compared to those who had not (p<0.001). Regression results showed that significant variables were perceptions towards GWG (p = 0.003) and experiencing weight stigma in pregnancy (p = 0.011).

Key conclusions and implications for practice: Perceptions towards GWG and experiencing weight stigma can influence body dissatisfaction in pregnancy. Given the detrimental physical and psychological consequences of body dissatisfaction, effective strategies to reduce prenatal weight stigma are needed, such as training maternal healthcare providers to offer sensitive preconception and prenatal weight counselling.

Keywords: Body image; Gestational weight gain; Obesity; Preconception; Pregnancy; Weight stigma.

MeSH terms

Body Dissatisfaction*
Body Mass Index
Cross-Sectional Studies
Female
Gestational Weight Gain*
Humans
Obesity / complications
Obesity / psychology
Pregnancy
Pregnancy Complications*
Weight Gain
Weight Prejudice*