Weight stigma from close others may drive reduced adherence to physical activity and nutrition recommendations during pregnancy and postpartum

PROBLEM: Weight stigma, defined as negative misconceptions and stereotypes associated with weight, is a social issue in pregnancy and postpartum that can impair engagement in healthy behaviours. BACKGROUND: Previous studies have not tested the behavioural implications of weight stigma on integral factors that promote maternal and newborn wellbeing, including physical activity (PA) and nutrition. AIM: To evaluate the relationship between experiencing weight stigma from close others (i.e., family, friends, partners) in pregnancy and postpartum and adherence to PA and nutrition recommendations. METHODS: Cross-sectional surveys were administered online at ≥13 weeks pregnant, and 3 months postpartum. In both surveys, participants indicated whether they had experienced weight stigma from close others, PA levels, and if their nutrition behaviours had stayed the same/worsened or improved. Participants were grouped as active or inactive referring to international prenatal PA guidelines, and as improved or stayed the same/worsened nutrition. Logistic regression analyses tested the relationship between frequency of weight stigma and adherence to recommendations. Significance was accepted as p < 0.05. FINDINGS: The surveys were completed by 463 participants, and 397 (85.7%) had experienced weight stigma in pregnancy and 341 (74.6%) in postpartum. Frequency of weight stigma was significantly associated with adherence to prenatal PA (β=0.59, Odds Ratio [OR]=1.80, 95% Confidence Interval [CI]=1.3, 2.3, p < 0.001), prenatal nutrition (β=0.44, OR=1.56, 95% CI=1.2, 1.9, p < 0.001), and postpartum PA (β=0.26, OR=1.30, 95% CI=1.0, 1.6, p = 0.019). CONCLUSION: Weight stigma from close others in pregnancy and postpartum may reduce adherence to PA and nutrition recommendations, thus strategies to mitigate weight stigma are warranted.