Behaviours of overweight and obese women during pregnancy who achieve and exceed recommended gestational weight gain

Abstract

Summary Background Excessive gestational weight gain (GWG) is associated with increased risk of pregnancy-related complications, postpartum weight retention, and long-term obesity. Little is known about the behavioural habits of pregnant women who achieve and exceed recommended GWG. Method In 2011, qualitative interviews were conducted in Pennsylvania with post-partum women who were overweight or obese prior to pregnancy to ascertain their behaviours and attitudes regarding dietary habits, physical activity, and self-monitoring during pregnancy. Thematic analysis identified the habits of women who achieved and exceeded recommended GWG guidelines. Results Of the 29 women interviewed, 11 had appropriate GWG and 18 had excessive GWG. Women achieving appropriate GWG reported modest increases in caloric intake if at all, with deliberate meal and snack planning, while women with excessive GWG described “eating-for-two.” Nearly all women with excessive GWG reported exercising less during pregnancy (or remaining sedentary), while women with appropriate GWG largely increased or maintained pre-pregnancy physical activity levels. About half of the sample reported self-monitoring weight gain during pregnancy, but women achieving recommended GWG tied their weight monitoring with GWG goals consistent with recommended guidelines. Conclusions Women who achieved appropriate GWG reported deliberate dietary habits and physical activity planning, with appropriate GWG goals during pregnancy. Women exceeding recommended GWG described “eating-for-two,” were sedentary, and either had no goals for GWG or intended to gain more weight than recommended.

Antenatal Weight Management: Women’s Experiences, Behaviours, and Expectations of Weighing in Early Pregnancy

“…However, a deeper examination revealed several narratives. In line with previous work [18, 27, 32, 33, 35, 37], women did not feel that their weight or indeed diet and exercise were priorities for midwives and other healthcare professionals. In the current study practitioners detached from the subject by employing terminology such as “BMI” and actions such as “keep an eye on [your weight].” Women also reported that there were not ready opportunities to ask questions about “nonroutine” or “nonemergency” topics.…”

“…This phenomenon of self-monitoring has been reported elsewhere; for example, women who disengaged from an antenatal weight service cited confusion and disappointment about not being weighed regularly [34, 35] and reported self-monitoring in half of the sample of women which included those who exhibited both recommended and excess gestational weight gain. What is less clear are women's motivations for regular weighing.…”

A mobile health intervention promoting healthy gestational weight gain for women entering pregnancy at a high body mass index: the txt4two pilot randomised controlled trial

“…Moreover, pregnant women are more likely to nominate barriers than enablers to changing behaviour, particularly diet changes which impacted others, such as family. Additionally, previous research has shown the ‘minor disorders of pregnancy’ such as food cravings, nausea and vomiting can be barriers to women making healthy dietary changes . Thirdly, research suggests that some women may view pregnancy as an opportunity to exercise less dietary restraint than other times in the life course .…”

Crowdsourcing and the Accuracy of Online Information Regarding Weight Gain in Pregnancy: A Descriptive Study

“…Perhaps the same reluctance among clinicians to discuss the sensitive subject of weight may also apply to online contributors who may not want to offend their pregnant readers by discussing specific weight gain guidelines on their websites. This lack of information, from both clinicians and the Internet, may be compounded by misinformation, such as the widespread cultural belief of “eating for two,” that is often perpetuated and reinforced by pregnant women’s friends and family members [36-39]. …”