The WOMBS Framework: A review and new theoretical model for investigating pregnancy‐related weight stigma and its intergenerational implications

Rodriguez, Angela C. Incollingo; Nagpal, Taniya S.

doi:10.1111/obr.13322

Cited by 30 publications

(24 citation statements)

References 119 publications

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“…A prominent environment where pregnant individuals who have higher weight or obesity report experiencing weight stigma is in healthcare [ 1 , 13 , 39 ]. Causal factors of weight stigma in healthcare have included receiving judgement about excessive weight gain, getting generic advice about being physically activity and eating well, and sensing healthcare provider discomfort when having weight-related conversations [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, there is a correlation between frequency of weight stigmatizing experiences in pregnancy and maternal body mass index (BMI), suggesting pregnant individuals who have higher weights or obesity are at greater risk of weight stigma and potential associated complications [ 11 ]. Negative maternal exposures can have a detrimental impact on fetal development and postpartum health for both the mother and child; therefore, weight stigma in the gestational period can have a multigenerational effect and mitigation strategies are essential [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Exploring weight bias internalization in pregnancy

Nagpal

Salas

Vallis

et al. 2022

BMC Pregnancy Childbirth

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Background Recent research has shown that pregnant individuals experience weight stigma throughout gestation, including negative comments and judgement associated with gestational weight gain (GWG). Weight bias internalization (WBI) is often a result of exposure to weight stigma and is detrimental to biopsychological health outcomes. The purpose of this study was to explore WBI in pregnancy and compare scores based on maternal weight-related factors including pre-pregnancy body mass index (BMI), obesity diagnosis and excessive GWG. Methods Pregnant individuals in Canada and USA completed a modified version of the Adult Weight Bias Internalization Scale. Self-reported pre-pregnancy height and weight were collected to calculate and classify pre-pregnancy BMI. Current weight was also reported to calculate GWG, which was then classified as excessive or not based on Institute of Medicine (2009) guidelines. Participants indicated if they were diagnosed with obesity by a healthcare provider. Inferential analyses were performed comparing WBI scores according to pre-pregnancy BMI, excessive GWG, and obesity diagnosis. Significance was accepted as p < 0.05 and effect sizes accompanied all analyses. Result 336 pregnant individuals completed the survey, with an average WBI score of 3.9 ± 1.2. WBI was higher among those who had a pre-pregnancy BMI of obese than normal weight (p = 0.04, η2 = 0.03), diagnosed with obesity than not diagnosed (p < 0.001, Cohen’s d = 1.3), and gained excessively versus not (p < 0.001, Cohen’s d = 1.2). Conclusions Pregnant individuals who have a higher BMI, obesity and gain excessively may experience WBI. Given that weight stigma frequently occurs in pregnancy, effective person-oriented strategies are needed to mitigate stigma and prevent and care for WBI.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Exploring weight bias internalization in pregnancy

Nagpal

Salas

Vallis

et al. 2022

BMC Pregnancy Childbirth

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“…Auch der kindliche Gewichtsverlauf wird durch die Säuglingsernährung bestimmt. Kinder, die gestillt werden, haben ein geringeres Risiko für kindliches Übergewicht und Adipositas im Vergleich zu Kindern, die Formula-Nahrung erhalten 32 33 . Umgekehrt konnte gezeigt werden, dass nicht gestillte Kinder und Kinder mit kurzer Stilldauer, im Vergleich zu gestillten Kindern (≥6 Monate), ein höheres Risiko für spätere Adipositas aufweisen 28 .…”

Section: Risikofaktoren Von Adipositas In Den Ersten 1000 Tagenunclassified

Adipositasprävention in den ersten 1000 Tagen

Raab

Geyer

Hauner

2022

Adipositas - Ursachen, Folgeerkrankungen, Therapie

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ZusammenfassungIn den ersten 1000 Tagen werden die Weichen für die langfristige Gesundheit von Mutter und Kind gestellt. Übergewicht, eine exzessive Gewichtzunahme in der Schwangerschaft sowie ein ungünstiger Lebensstil wirken sich kurz- und langfristig negativ auf die Gesundheit von Mutter und Kind aus. Die hohe Prävalenz von Übergewicht und Adipositas bei Frauen im gebärfähigen Alter sowie die steigende Zahl von Kindern und Jugendlichen mit Übergewicht oder Adipositas stellen ein wachsendes Gesundheitsproblem dar. Die Prädisposition für die spätere Gewichtsentwicklung beginnt bereits im Mutterleib. Primärpräventive Maßnahmen sind daher besonders sinnvoll. Bisherige Studien zu Lebensstilinterventionen in der Schwangerschaft zeigten moderat positive Effekte auf Gewichts- und Gesundheitsparameter der Mutter, wirkten sich jedoch nicht auf die Gewichtsentwicklung der Kinder aus. Es sind daher neue Präventionskonzepte erforderlich, die früher beginnen, risikoadaptiert sind und sich flächendeckend in die Praxis implementieren lassen. Digitale Maßnahmen wie Smartphone-Applikationen (Apps) könnten hierbei eine sinnvolle Unterstützung bieten. Die Zahl an aussagekräftigen Studien zur Erprobung App-gestützter Interventionen ist noch dürftig, erste Ergebnisse deuten jedoch auf positive Effekte hin. Die Herausforderung für die kommenden Jahre wird sein, solche Ansätze zur Unterstützung einer gesunden Lebensweise rund um die Schwangerschaft zu entwickeln, zu evaluieren und zu implementieren, um die langfristige Gesundheit von Mutter und Kind wirksamer zu schützen.

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“…In fact, focusing on weight in the absence of the other health measures may perpetuate weight-related stigma (137,138) . This is especially important in the context of pregnancy which has been identified as a particularly vulnerable time for weight stigma (139) .…”

Section: Further Assessment In Overweight and Obesitymentioning

confidence: 99%

Addressing the gaps in nutritional care before and during pregnancy

et al. 2021

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The present paper outlines current issues in the nutritional care of women during pregnancy and potential resources to address them. Globally, overnutrition, undernutrition and nutritional imbalances are widespread among women of reproductive age; increasing the risk of pregnancy complications and non-communicable diseases in both mothers and their children. Most women do not meet dietary guidelines for pregnancy. The World Health Organisation (WHO) recommends nutrition and weight counselling during pregnancy for all women. However, clinical practices focusing on nutrition vary and there is no consensus on which outcomes are most important for pregnancy nutrition interventions, with little consideration for the ‘patient voice’. The International Federation of Gynaecology and Obstetrics (FIGO) nutrition checklist is a clinical practice tool that is available for healthcare professionals that will address this issue. The pregnancy nutrition core outcome set will also support advancement of antenatal nutrition by identifying the most critical nutrition-related outcomes from the perspective of healthcare professionals, researchers and women with experience of pregnancy. While poor nutrition can result in adverse outcomes across women of all weight categories, those with obesity may require specialist care to reduce their risk. Obesity is a chronic, progressive, relapsing disease that has high individual variability in its prognosis. The use of obesity staging systems, which consider mental, physical and functional health, can stratify individuals into risk categories and aid in treatment prioritisation in pregnancy. As the prevalence of obesity continues to rise, an obesity staging approach may support clinicians, especially those in limited resource settings.

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The WOMBS Framework: A review and new theoretical model for investigating pregnancy‐related weight stigma and its intergenerational implications

Cited by 30 publications

References 119 publications

Exploring weight bias internalization in pregnancy

Exploring weight bias internalization in pregnancy

Adipositasprävention in den ersten 1000 Tagen

Addressing the gaps in nutritional care before and during pregnancy

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