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Nagpal TS, Pearce N, Adamo KB. Presentation of a weight bias internalization tool for use in pregnancy and a call for future research: A commentary. OBESITY PILLARS 2024; 10:100107. [PMID: 38524875 PMCID: PMC10957497 DOI: 10.1016/j.obpill.2024.100107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 03/26/2024]
Abstract
Background Emerging evidence has shown that weight stigma is a concern during pregnancy, with several studies documenting common sources including healthcare, the media and interpersonal networks. Experiencing weight stigma may lead to weight bias internalization (WBI), whereby individuals accept and self-direct negative weight-related stereotypes, and limited research has assessed this in the context of pregnancy. Pregnancy is unique in terms of weight changes as many individuals will experience gestational weight gain (GWG). Accordingly, a WBI tool that accounts for GWG may be a more population-specific resource to use. Methods This commentary presents a pregnancy-specific WBI tool that accounts for GWG. The validated Adult WBI scale was modified to include 'pregnancy weight gain'. This commentary also presents a brief summary of research that has assessed WBI in pregnancy and recommendations for future work. Results Recommended future work includes validation of the pregnancy-specific WBI tool and prospective examinations of weight stigma and WBI in pregnancy and implications on maternal and newborn outcomes. Conclusion Ultimately this research may inform development of interventions and resources to mitigate weight stigma and WBI in pregnancy and overall may contribute to improving prenatal outcomes and experiences.
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Affiliation(s)
- Taniya S. Nagpal
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
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Perera M, Hawk GS, Nagpal TS, Tinius RA. Social support for exercise from pregnancy to postpartum and the potential impact of a mobile application: A randomized control pilot trial in Southern United States. Prev Med Rep 2023; 36:102485. [PMID: 37954963 PMCID: PMC10637991 DOI: 10.1016/j.pmedr.2023.102485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 11/14/2023] Open
Abstract
This study compared perceived social support among women of all body mass index (BMI) categories with an attempt to assess the efficacy of the BumptUp® mobile application to improve social support for exercise during pregnancy and postpartum. Thirty-five pregnant women living in Southern United States were included in the sample. The intervention group received access to the BumptUp® mobile application that was designed to promote physical activity during pregnancy and postpartum. The control group received an evidence-based educational brochure. Perceived social support for exercise was assessed at four-time points using the social support and exercise survey. Outcomes were evaluated at 23-25, 35-37 gestational weeks, and 6 and 12 weeks postpartum. Based on their pre-pregnancy weight and height, BMI was computed to categorize participants into lean, overweight, and obese groups. Social support across BMI categories and between control and intervention groups were compared using linear mixed-effect models. Women grouped in the overweight and obese BMI categories reported receiving significantly lower levels of social support for exercise than women in the lean category throughout pregnancy and postpartum during mid-pregnancy, late pregnancy, and at 12 weeks postpartum (p < 0.05). Although the intervention group received higher social support than the control group throughout all four assessment points, the difference was not statistically significant (p > 0.05). Women with a pre-pregnancy BMI of overweight and obese received lower social support for exercise during pregnancy and postpartum. The efficacy of BumptUp® to improve perceived social support for exercise in pregnancy and postpartum was not evident in the results.
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Affiliation(s)
- Madhawa Perera
- Exercise Science, Western Kentucky University, Bowling Green, KY 42101, USA
| | - Gregory S. Hawk
- Department of Statistics, University of Kentucky, Lexington, KY 40506, USA
| | - Taniya S. Nagpal
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Rachel A. Tinius
- Exercise Science, Western Kentucky University, Bowling Green, KY 42101, USA
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Nagpal TS, Salas XR, Vallis M, Piccinini-Vallis H, Alberga AS, Bell RC, da Silva DF, Davenport MH, Gaudet L, Rodriguez ACI, Liu RH, Myre M, Nerenberg K, Nutter S, Russell-Mayhew S, Souza SCS, Vilhan C, Adamo KB. Exploring weight bias internalization in pregnancy. BMC Pregnancy Childbirth 2022; 22:605. [PMID: 35906530 PMCID: PMC9338529 DOI: 10.1186/s12884-022-04940-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/22/2022] [Indexed: 11/12/2022] Open
Abstract
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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Affiliation(s)
- Taniya S Nagpal
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada. .,Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada.
| | | | - Michael Vallis
- Department of Family Medicine, Dalhousie University, Halifax, NS, Canada
| | | | - Angela S Alberga
- Department of Health, Kinesiology & Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Rhonda C Bell
- Department of Agricultural, Food and Nutritional Sciences, Faculty of ALES, University of Alberta, Edmonton, AB, Canada
| | - Danilo F da Silva
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Margie H Davenport
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Laura Gaudet
- Department of Obstetrics and Gynecology, Queen's University, Kingston, ON, Canada
| | - Angela C Incollingo Rodriguez
- Psychological & Cognitive Sciences, Social Science and Policy Studies, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Rebecca H Liu
- Women's College Hospital Institute for Health System Solutions and Virtual Care (WIHV), Toronto, ON, Canada
| | - Maxine Myre
- Werklund School of Education, University of Calgary, Calgary, AB, Canada
| | - Kara Nerenberg
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sarah Nutter
- Department of Educational Psychology and Leadership Studies, University of Victoria, Victoria, BC, Canada
| | | | - Sara C S Souza
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Candace Vilhan
- Obesity Canada, Patient Advocate Volunteer, Edmonton, AB, Canada
| | - Kristi B Adamo
- Department of Agricultural, Food and Nutritional Sciences, Faculty of ALES, University of Alberta, Edmonton, AB, Canada
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