Association Between Body Image Before and During Pregnancy and Gestational Weight Gain in Japanese Women: A Prospective Cohort Study

Abstract

Objectives More than half of women do not achieve appropriate gestational weight gain. Maternal body image may be an important factor associated with gestational weight gain. However, this association has not been thoroughly evaluated. We aimed to elucidate whether body image parameters before and during pregnancy are associated with gestational weight gain in Japanese women. Methods This prospective cohort study was conducted at a hospital in Osaka, Japan from March 2020 to March 2021. We recruited women with singleton pregnancies in their second and third trimesters. Body image was assessed using the Pregnancy and Weight Gain Attitude Scale and additional questions. Gestational weight gain was classified as insufficient, appropriate, or excessive based on recommended ranges in Japan. One-way analysis of variance, chi-square tests, and multinomial logistic regression analyses were performed to identify factors associated with insufficient or excessive weight gain. Results Of 266 enrolled women, 47 had insufficient weight gain and 100 had excessive weight gain during pregnancy. Risk factors for excessive gestational weight gain included a history of dietary restriction before pregnancy, negative attitudes toward gestational weight gain, and perception of body shape as fat and body shape dissatisfaction during pregnancy. Perception of body shape as thin during pregnancy was identified as a risk factor for insufficient gestational weight gain. Conclusions Body image before and during pregnancy may be an important factor in preventing insufficient or excessive gestational weight gain in Japanese women. Healthcare professionals should consider body image when providing health guidance on weight management to pregnant women.

Impact of altered gestational weight gain guidelines on midwives in Japan: A cross-sectional study

“…In Japan, in order to prevent hypertensive disorders during pregnancy, strict weight control guidance has been provided to pregnant women. [4] Furthermore, incorrect body shape recognition and an excessive desire for thinness have caused insufficient GWG in Japan, [17] subsequently resulting in LBW neonates. [18] Meanwhile, 50.4% of participants thought the recommended amount of GWG was neither good nor bad and chose "impact after changing the guideline is not clear" or "worried about the impact on pregnant women's health due to gaining too much weight."…”

Association between gestational weight gain and behavioral problems of the offspring aged 6–7 years: A population‐based study in Japan

“…30 Japanese women in this age group often have negative views about their bodies, characterized by an overestimation of body shape and a strong desire to be thin. 31,32 These attitudes are shaped by societal norms that consider being thin as a positive image. 32 Women with a negative body image face an elevated risk of adopting self-imposed dietary restrictions during pregnancy, leading to inadequate GWG.…”