Eating attitudes and behaviors in pregnancy and postpartum: Global stability versus specific transitions

Abstract

Global changes in eating attitudes were examined prospectively across pregnancy and 4 months postpartum in a sample of 90 women. In addition, specific changes in dieting behavior and weight/shape satisfaction were assessed at 4 months postpartum for concurrent and retrospective time points. Measures included the Eating Attitudes Test (EAT) and weight/shape satisfaction in pregnancy and at 4 months postpartum, as well as prepregnancy, pregnancy, and postpartum weight loss efforts. While global EAT scores were stable across time, dieting scores (Factor I) increased between pregnancy and postpartum. Weight/shape satisfaction was higher in pregnancy, and satisfaction was related to EAT scores at 4 months postpartum but not during pregnancy. Prepregnancy dieters and nondieters were best discriminated by higher weights, elevated pregnancy dieting scores, and lower postpartum weight/shape satisfaction. Results emphasize the importance of looking beyond changes in global eating attitudes and behaviors to more specific eating concerns or behaviors. Lastly, the results have implications for identifying women at risk for eating- and weight-related concerns during this period of rapid physical change.

Effects of pregnancy on eating attitudes and disorders

“…The dimensions that more clearly show this course are body satisfaction, impulse to thinness and bulimia scores, as Baker et al [13] and Davies and Wardle [11] also underline in their studies.…”

“…Baker et al [13] compared eating habits before, during and after pregnancy, underlining that women with a history of eating restrictions were unsatisfied about body image and weight and their feelings worsened in late pregnancy and after delivery.…”

Weight concerns affect motivation to remain abstinent from smoking postpartum

“…Specifically, weight concerns relate to women's motivation to remain abstinent after childbirth, and interventions designed to prevent postpartum smoking relapse may need to address women's concerns about eating and weight. Because weight concerns are likely to be salient during the postpartum period (28,29), helping women modify misconceptions about smoking and weight and increase shape and weight acceptance may minimize postpartum smoking relapse. Smoking cessation programs that target weight concerns have been developed (41,42), and there is evidence that addressing women's concerns about weight gain, in the absence of weight modification information, improves long-term smoking cessation outcome (43).…”

“…A considerable number of women report the use of smoking to control their body weight (24,25) or concerns about weight gain related to quitting smoking (26,27). Evidence suggests that shape and weight concerns increase during the postpartum period (28,29), and preliminary data indicate that concerns about weight (2,15) relate to postpartum smoking. Thus, for vulnerable women, such as those who have a tendency to easily lose control over food intake, the resumption of smoking postpartum may represent an effort at weight control.…”

Do changes in mood and concerns about weight relate to smoking relapse in the postpartum period?

“…Most women retain a portion of the weight gained during pregnancy in the year after delivery (Keppel and Taffel, 1993), and pregnancy has been related to the development of weight problems among women (Walker, 1995). In addition, maladaptive eating attitudes, dieting behaviors and concerns about shape or weight increase during the postpartum period (Baker et al, 1999;Stein and Fairburn, 1996).…”