Factors influencing engagement in postnatal weight management and weight and wellbeing outcomes
Many women exceed gestational weight gain recommendations. Successful postnatal weight management decreases the risk of entering further pregnancies obese.
This service evaluation investigates women's motivations to lose weight postnatally, the weight loss achieved and the impact on the women's self-esteem.
An online survey was used, with quantitative questions to determine motivation and lifestyle behaviours related to postnatal weight management in women attending a commercial weight management organisation. Weekly weights were confirmed from digitally recorded data.
A total of 1015 women responded. Mean body mass index at joining was 33.3 kg/m2 ± 5.85 and, when surveyed, 30.5 kg/m2 ± 5.86, a change of –2.8 ± 0.1 kg/m² (P < 0.01; 95% CI 2.76–3.11). 463 women (45.6%) joined the groups between 6–26 weeks postnatal. The main motivators to lose weight were to ‘improve how I feel about my body size and shape’ (85.2%) and ‘improve self-confidence’ (76.6%); however, only ‘to improve my health’ (65.6%) correlated with actual weight loss (0.114, P < 0.01). Health professionals' recommendation was less of a reason (6.5%). Improvements in self-confidence (77.6%), self-esteem (78.6%), wellbeing (85.2%) and body size/shape (70.0%) were reported.
Women chose to engage in the weight management service to improve their self-confidence, feelings about their body shape, and health. There is an opportunity for health professionals to encourage women early after giving birth to engage in weight loss, which may improve outcomes.
Of the four million women who give birth in the USA each year, almost 30% gain more weight than recommended by the Institute of Medicine guidelines (Rasmussen and Yaktine, 2009). It has been established for many years that pregnancy may lead to subsequent weight problems. In the Stockholm Pregnancy and Women's Nutrition (SPAWN) longitudinal study, weight retention at the end of the first year postpartum was the main predictor of being overweight 15 years later (Linné et al, 2004).
In the UK, 24% of women of reproductive age are now obese, and the prevalence is predicted to increase (Butland et al, 2007). Maternal obesity increases health risks for the woman and child, both during and after pregnancy, including hypertensive disorders, thromboembolism, gestational diabetes mellitus, induction of labour, prolonged birth, caesarean section, postpartum haemorrhage and either low birth weight or macrosomia in the infant (Scott-Pillai et al, 2013). The more weight the woman gains during pregnancy, the more likely it is that the weight may be retained postpartum (Johnson et al, 2013). Women who enter a subsequent pregnancy overweight or obese have a higher risk of adverse outcomes for themselves and/or their infants.
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