Body image and gestational weight gain: a prospective study

Approximately 50% of Australian adult women of childbearing age are overweight or obese, and, when pregnant, the majority gain excessive weight; this is also the case in the United States and other developed nations. High gestational weight gain (GWG) is the strongest predictor of maternal overweight/obesity postbirth and is also associated with an increased risk of childhood obesity. Understanding factors that contribute to excessive GWG is vital in combating obesity. The aim of the current study was to examine whether body image attitudes (eg, feeling fat, attractive, or strong and fit, and salience of weight and shape) predict GWG.

Pregnant women, recruited through advertisements on pregnancy online forums and parenting magazines, completed questionnaires assessing body image, demographic variables, and GWG. The Body Attitudes Questionnaire assessed body image in early-to-middle, middle, and late pregnancy (mean of 16.8, 24.7, and 33.0 weeks' gestation, respectively). Total GWG was calculated by subtracting self-reported pre pregnancy weight from self-reported weight at 36.8 weeks' gestation.

A total of 150 pregnant women responded to the study's advertisements, and 72% (n = 108) took part. After controlling for pre pregnancy body mass index (BMI), lower attractiveness in early-to-middle pregnancy was associated with higher GWG. In late pregnancy, women who had the lowest feelings of fatness had greater GWG. Body image attitudes earlier in pregnancy did not predict whether GWG recommendations were exceeded. Women of higher BMI were more likely to gain excessive weight.

The findings suggest that the type and timing of pregnancy, body attitudes, and the time of pregnancy when they are noted, predict GWG. However, more research in the area is needed, including assessment of the relationship between body image concerns, GWG, and other psychosocial factors. We recommend that midwives monitor body image concerns in pregnancy to help address factors affecting GWG in at-risk women.