Internalized Weight Bias, Weight-Related Experiences, And Peripartum Weight

Perceived weight stigma and disordered eating behaviors among postpartum women: The mediating role of weight bias internalization and postpartum depression

Background

Weight stigma is linked to adverse effects, but whether it directly heightens the risk of disordered eating behaviors or psychological factors mediate this connection among postpartum women is uncertain.

Objectives

To investigate the relationship between perceived weight stigma and disordered eating behaviors (restrained eating, emotional eating, and external eating) and identify the mediating role of weight bias internalization and postpartum depression (PPD).

Methods

This cross-sectional study involved 507 postpartum women. Data were collected anonymously using self-reported questionnaires, including the Perceived Weight Stigma Questionnaire, Weight Bias Internalization Scale, Edinburgh Postpartum Depression Scale, and Dutch Eating Behavior Questionnaire. Data were analyzed using descriptive statistics, Pearson's correlation analysis, hierarchical linear regression, and mediation analysis.

Results

The results showed that the relationship between perceived weight stigma and disordered eating behaviors was fully mediated by weight bias internalization and PPD. Specifically, perceived weight stigma was associated with greater weight bias internalization, which was associated with greater PPD, and greater PPD was associated with greater disordered eating behaviors.

Conclusion

This may be the first study to propose a chain mediation model exploring the roles of weight bias internalization and PPD in the relationship between perceived weight stigma and disordered eating behaviors among postpartum women. The findings enhance the understanding of the psychological impacts of perinatal weight stigma and underscore the importance of addressing weight stigma in postpartum care. Comprehensive interventions should be developed to enhance postpartum health and reduce the risk of disordered eating behaviors.

Pregnancy and weight gain: a scoping review of women's perceptions and experiences with stigma

BACKGROUND

Weight stigma can impact any woman who considers herself as overweight, regardless of BMI. Pregnant women are at risk of experiencing stigma related to weight which harm their physical and mental health. To support and guide on healthy weight gain during pregnancy, it is important to explore women's perceptions and experiences of weight related stigma. This can inform programs and policies to improve maternal and child health outcomes. A scoping review on this issue will provide valuable insights, identify gaps in current research, and establish a foundation for informed interventions.

METHODS

A search syntax was created to retrieve the relevant results from PubMed and Google Scholar. A scoping review was undertaken of published peer reviewed research indexed in these databases, which were written in English, and focused only on primary studies. The methodology for this scoping review was based on the framework proposed by Arksey and O'Malley (2005) and the subsequent recommendations provided by Levac et al. (2010).

RESULTS

From a total of 3109 articles identified using search terms, 85 articles were included for review. There are four themes in this scoping review: pregnant women's perceptions and experience with healthcare givers; pregnant women's experience with family and friends; pregnant women's experience with other members of society; and pregnant women's experience with the media. Weight stigmatization can hinder the communication between healthcare providers and women leading to misunderstanding and compromising the quality of care. This can prevent women from seeking necessary care. Stigmatizing behavior of friends, family and the perpetuation of stigma in the media influences how women perceive their pregnancy weight gain, intensifies feelings of shame, isolation and negatively impacts women's mental well-being and body image during pregnancy.

CONCLUSION

This scoping review examines the perceptions and experiences of weight stigma among pregnant women, focusing on their interactions with healthcare providers, family and friends, other members of society and stigma perpetuated by the media. The review gives an insight into how weight stigma can heighten women's stress and also leads to the avoidance of essential medical care, which affect the health of both the mother and the child. Addressing stigma from various sources is crucial for the general well-being and health of both women and children.

Weight stigma in the preconception, pregnancy, and postpartum periods: A systematic review of women's perspectives

Weight stigma presents a significant challenge for women throughout the preconception, pregnancy, and postpartum (PPP) periods, manifesting in multiple areas of life, including interpersonal relationships, healthcare settings, and broader social contexts. This systematic review investigates weight stigma in women across their reproductive years, examining its impact, and exploring the socioecological factors that contribute to its persistence. We searched Medline, PsycINFO, Embase, Maternity and Infant Care (MIDIRS), and Global Health for peer-reviewed articles published since 2010. Of the 3486 records identified, 38 were included in a narrative synthesis. Inductive thematic analysis was used to explore women's personal experiences of weight stigma. We then applied a socioecological lens to examine the interrelationships between individual, interpersonal, organizational, and societal factors contributing to weight stigma. Five overarching themes were identified: (1) the impact of weight stigma on PPP women; (2) weight stigma experiences across the socioecological contexts; (3) coping strategies; (4) women's voices as a call to action; and (5) interrelationships of weight stigma contexts. Our findings provide critical insights into the multifaceted nature of weight stigma, highlighting the need for future research, and the development of practical strategies that prioritize women's perspectives, and challenge harmful societal norms for positive change.

Presentation of a weight bias internalization tool for use in pregnancy and a call for future research: A commentary

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.

Effect of mode of delivery on postpartum weight retention: A systematic review and meta-analysis

OBJECTIVE

Retention of weight gained over pregnancy increases the risk of long-term obesity and related health concerns. While many risk factors for this postpartum weight retention have been examined, the role of mode of delivery in this relationship remains controversial. We carried out a systematic review and meta-analysis to determine the effect of mode of delivery on postpartum weight retention.

METHODS

Ten electronic databases including PubMed, Cochrane Library, EMBASE, Web of Science, MEDLINE, CINAHL, China National Knowledge Infrastructure (CNKI), Wan-Fang database, the VIP database and China Biology Medicine Database (CBM) were searched from inception through November 2022. Review Manager 5.4 was used to pool the study data and calculate effect sizes. For dichotomous data, the odds ratio and 95 % confidence interval were used to report the results. For continuous data, the mean difference (MD) and 95 % confidence interval were used to report the results. The outcomes were the amount of postpartum weight retention and the number or proportion of women who experienced postpartum weight retention. The Newcastle- Ottawa Scale (NOS) and GRADE Guidelines were used to assess the methodological quality of the included studies.

FINDINGS

A total of 16 articles were included in the systematic review and 13 articles were included in the meta-analysis. The results showed that the mode of delivery had a significant effect on postpartum weight retention, women who delivered by caesarean section were more likely to experience postpartum weight retention compared to those who delivered vaginally. Sensitivity analysis showed that the results were stable and credible.

CONCLUSION

Due to the limitations of this study, the findings need to be treated with caution. And, to better prevent the postpartum weight retention, future practice and research need to further focus on upstream modifiable factors.