Weight stigma and prenatal physical activity: Exploring the perspectives of pregnant women living with obesity

Nagpal, Taniya S.; Liu, Rebecca; Myre, Maxine; Gaudet, Laura; Cook, Jocelynn L.; Silva, Danilo F. da; Adamo, Kristi B.

doi:10.1016/j.midw.2021.103186

Cited by 6 publications

(10 citation statements)

References 35 publications

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“…Women with GDM have self-image stigma and shame due to their overweight/obese, accompanied by adverse emotional reactions (Nagpal et al, 2021). In contrast, some women think they are healthy and do not need to care about their weight.…”

Section: Discussionmentioning

confidence: 99%

Puerperium experience and lifestyle in women with gestational diabetes mellitus and overweight/obesity in China: A qualitative study

Hu²,

Chen³

et al. 2023

Front. Psychol.

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IntroductionWomen with overweight or obesity and gestational diabetes mellitus (GDM) are at a high risk of developing type 2 diabetes mellitus (T2DM) and other metabolic diseases. Healthy postpartum lifestyles in women with GDM are important for effectively preventing early T2DM occurrence; however, few studies and guidelines focus in China on this issue.AimsThis qualitative study aimed to understand the puerperium experience and lifestyle of women with overweight/obesity and GDM.MethodsA face-to-face, in-depth, and semi-structured interview was conducted using a hermeneutical phenomenology method to collect data that were analyzed through thematic analysis.ResultsOut of 61 recruited women with overweight/obesity and history of GDM, 14 women underwent an interview and provided detailed descriptions of their lifestyle experiences during puerperium. The interview data were used to generate four themes—puerperium dietary behavior, weight perception and “confinement” behavior, family support, disease knowledge, and perceived risk—and nine sub-themes.ConclusionUnhealthy lifestyles, misconceptions about food, the conflict between physical activity and confinement behavior, a lack of social and family support, and low awareness of disease risk are all common among overweight/obese women with a history of GDM. Thus, we emphasized that healthcare providers should provide continuous preventive care from pregnancy to postpartum and promote long-term health in high-risk populations with a history of GDM associated with overweight/obesity.

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Section: Discussionmentioning

confidence: 99%

Puerperium experience and lifestyle in women with gestational diabetes mellitus and overweight/obesity in China: A qualitative study

Hu²,

Chen³

et al. 2023

Front. Psychol.

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“… 29 As weight stigma is a barrier to healthy behaviors, Ontario pregnant women living with obesity articulated that exercise recommendations tailored to different body sizes and visual representations of pregnant people living with obesity in health promotion would be helpful. 39 …”

Section: Discussionmentioning

confidence: 99%

Best practices in prenatal health promotion: Perceptions, experiences, and recommendations of Ottawa, Canada, prenatal key informants

Soucy

Terrell

Chedid

et al. 2023

Womens Health (Lond Engl)

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Background: Prenatal health promotion includes the provision of evidence-based information and practical skills to optimize maternal–fetal outcomes. Increasingly, prenatal education is delivered by both healthcare professionals and allied childbirth educators, in community- or hospital-based group classes, targeted outreach programs, and online modules. Objectives: To better understand how prenatal health promotion relates to a diverse urban community, we assessed the perspectives of Ottawa, Canada prenatal key informants. Design: This is a qualitative research with key informant interviews. Methods: Semi-structured interviews were conducted with 11 prenatal key informants, responsible for the design, delivery, or promotion of publicly available prenatal health services. Interviews explored concepts and delivery of prenatal health promotion, strategies to address existing and emerging prenatal topics, identification of barriers to prenatal health services, and recommendations. Results: Key informants recommended a lifespan approach to prenatal health promotion, with an emphasis on healthy behaviors, emotional health, labor and delivery, and postpartum/early parenting. Recognizing community health disparities, key informants used community outreach, and intersectoral collaborations for Indigenous and other at-risk communities to mitigate barriers to prenatal service uptake. Conclusions: Ottawa key informants conceptualized prenatal health promotion as inclusive, comprehensive, and as an extension of preconception, school-based sexual education. Respondents recommended the design and delivery of prenatal interventions as culturally safe and trauma informed, using online modalities to complement in-person activities. The experience and intersectoral networks of community-based prenatal health promotion programs represent potential capacity to address emergent public health risks to pregnancy, particularly among at-risk populations. Plain Language Summary: A broad and diverse community of professionals deliver prenatal education to help people have healthy babies. We interviewed Ottawa, Canada experts in prenatal care/education to learn about the design and delivery of reproductive health promotion. We found that Ottawa experts emphasized healthy behaviors beginning before conception and through pregnancy. Community outreach was identified as a successful strategy to promote prenatal education to marginalized groups.

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“…Media representation of pregnancy appears to promote body ideals that exclude pregnant individuals who have larger bodies, and instead, they predominantly show smaller pregnant persons with a pronounced pregnant abdomen engaged in healthy eating and activity behaviours [ 2 ]. In fact, the lack of body diversity in prenatal media representation was identified as a barrier to engaging in healthy behaviours like physical activity [ 41 ]. Drawing from non-pregnant research, exposure to social messaging promoting smaller body ideals can increase WBI and result in further body image disturbances [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

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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Weight stigma and prenatal physical activity: Exploring the perspectives of pregnant women living with obesity

Cited by 6 publications

References 35 publications

Puerperium experience and lifestyle in women with gestational diabetes mellitus and overweight/obesity in China: A qualitative study

Puerperium experience and lifestyle in women with gestational diabetes mellitus and overweight/obesity in China: A qualitative study

Best practices in prenatal health promotion: Perceptions, experiences, and recommendations of Ottawa, Canada, prenatal key informants

Exploring weight bias internalization in pregnancy

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