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. 2023 Sep 13;23(1):1778.
doi: 10.1186/s12889-023-16676-7.

Barriers and facilitators for sustainable weight loss in the pre-conception period among Danish women with overweight or obesity - a qualitative study

Majken Lillholm Pico  1   2 , Louise Groth Grunnet  3 , Christina Anne Vinter  4   5 , Jens Aagaard-Hansen  6   7 , Karoline Kragelund Nielsen  6
Affiliations

Barriers and facilitators for sustainable weight loss in the pre-conception period among Danish women with overweight or obesity - a qualitative study

Majken Lillholm Pico et al. BMC Public Health. .

Abstract

Background: The prevalence of overweight or obesity in women of reproductive age continues to increase. A high pre-pregnancy body mass index (BMI) has been shown to increase the risk of pregnancy complications and predispose offspring to childhood obesity. However, little is known about factors affecting women's ability to achieve sustainable weight management and very few studies have applied behavior change theory to qualitative data.

Aim: This study aimed to explore barriers and facilitators for weight management among women with overweight or obesity, who wanted to lose weight before pregnancy.

Methods: We conducted semi-structured interviews with 17 women with a BMI ≥ 27 kg/m2, who planned to become pregnant in the near future. Data were analyzed using an abductive approach and the Capability, Opportunity, Motivation, and Behavior model was applied as a conceptual framework.

Results: The women's strongest motivator for pre-conception weight loss was their ability to become pregnant. Barriers to successful weight management included their partners' unhealthy behaviors, mental health challenges, competing priorities, and internalized weight stigmatization. The women described careful planning, partners' health behaviors, social support, and good mental health as facilitators for sustainable weight management.

Conclusion: Our study provides insights into factors affecting weight management among women with overweight or obesity in the pre-conception period. Future interventions on weight management require a holistic approach, including a focus on social support, especially from the partner, and mental health, as well as an effort to limit internalized weight stigma.

Keywords: COM-B model; Health behaviors; Obesity; Pre-conception; Psychosocial factors; Relationship dynamics; Weight loss; Weight stigma.

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Conflict of interest statement

All authors are employed at a Steno Diabetes Center, either in Copenhagen or Odense. Both Steno Diabetes Centers are public hospitals and research institutions in Denmark, which are partly funded by a grant from the Novo Nordic Foundation (NNF). NNF had no role in the design of the study; in the collection, analysis, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

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