Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul 29;22(1):605.
doi: 10.1186/s12884-022-04940-4.

Exploring weight bias internalization in pregnancy

Taniya S Nagpal  1   2 , Ximena Ramos Salas  3 , Michael Vallis  4 , Helena Piccinini-Vallis  4 , Angela S Alberga  5 , Rhonda C Bell  6 , Danilo F da Silva  7 , Margie H Davenport  8 , Laura Gaudet  9 , Angela C Incollingo Rodriguez  10 , Rebecca H Liu  11 , Maxine Myre  12 , Kara Nerenberg  13 , Sarah Nutter  14 , Shelly Russell-Mayhew  12 , Sara C S Souza  7 , Candace Vilhan  15 , Kristi B Adamo  6
Affiliations

Exploring weight bias internalization in pregnancy

Taniya S Nagpal et al. BMC Pregnancy Childbirth. .

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.

Keywords: Maternal health; Obesity; Pregnancy; Stigma; Weight bias.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

References

    1. Incollingo Rodriguez AC, Smieszek SM, Nippert KE, Tomiyama AJ. Pregnant and postpartum women’s experiences of weight stigma in healthcare. BMC Pregnancy Childbirth. 2020;20(1):499. doi: 10.1186/s12884-020-03202-5. - DOI - PMC - PubMed
    1. Nippert KE, Tomiyama AJ, Smieszek SM, Incollingo Rodriguez AC. The Media as a Source of Weight Stigma for Pregnant and Postpartum Women. Obesity (Silver Spring) 2021;29(1):226–32. doi: 10.1002/oby.23032. - DOI - PubMed
    1. Hill B, Incollingo Rodriguez AC. Weight Stigma across the Preconception, Pregnancy, and Postpartum Periods: A Narrative Review and Conceptual Model. Semin Reprod Med. 2020;38(6):414–22. doi: 10.1055/s-0041-1723775. - DOI - PubMed
    1. Puhl R, Suh Y. Health Consequences of Weight Stigma: Implications for Obesity Prevention and Treatment. Curr Obes Rep. 2015;4(2):182–90. doi: 10.1007/s13679-015-0153-z. - DOI - PubMed
    1. Puhl RM, Himmelstein MS, Pearl RL. Weight stigma as a psychosocial contributor to obesity. Am Psychol. 2020;75(2):274–89. doi: 10.1037/amp0000538. - DOI - PubMed