Butland B, Jebb S, Kopelman P, Mcpherson K, Thomas S, Mardell J, Parry VLondon: The Stationery Office; 2007

Heslehurst N, Rankin J, Wilkinson JR, Summerbell CD A nationally representative study of maternal obesity in England, UK: trends in incidence and demographic inequalities in 619 323 births, 1989-2007. Int J Obes (Lond). 2010; 34:(3)420-8

Hodgkinson EL, Smith DM, Wittkowski A Women's experiences of their pregnancy and postpartum body image: a systematic review and meta-synthesis. BMC Pregnancy Childbirth. 2014; 14:(1)

Johnson M, Campbell F, Messina J, Preston L, Buckley Woods H, Goyder E Weight management during pregnancy: A systematic review of qualitative evidence. Midwifery. 2013; 29:(12)1287-96

Khazaezadeh N, Pheasant H, Bewley S, Mohiddin A, Oteng-Ntim E Using service-users views to design a maternal obesity intervention. British Journal of Midwifery. 2011; 19:(1)49-56

Linné Y, Dye L, Barkeling B, Rössner S Long-term weight development in women: a 15-year follow-up of the effects of pregnancy. Obesity Res. 2004; 12:(7)1166-78

Montgomery KS, Bushee TD, Phillips JD, Kirkpatrick T, Catledge C, Braveboy K, O'Rourke C, Patel N, Prophet M, Cooper A, Mosley L, Parker C, Douglas GM Women's challenges with postpartum weight loss. Matern Child Health J. 2011; 15:(8)1176-84

NHS England. 2015. (accessed 17 October 2016)

National Institute for Health and Care Excellence. Weight management before, during and after pregnancy. 2010. (accessed 17 October 2016)

National Institute for Health and Care Excellence. Weight management: lifestyle services for overweight or obese adults. 2014. (accessed 17 October 2016)

National Institute for Health and Care Excellence. Maternal and child nutrition. 2015. (accessed 17 October 2016)

In: Rasmussen KM, Yaktine AL (eds). Washington DC: National Academies Press; 2009

Scott-Pillai R, Spence D, Cardwell CR, Hunter A, Holmes VA The impact of body mass index on maternal and neonatal outcomes: a retrospective study in a UK obstetric population, 20042011. BJOG. 2013; 120:(8)932-9

Stubbs RJ, Pallister C, Whybrow S, Avery A, Lavin J Weight outcomes audit for 34,271 adults referred to a primary care/commercial weight management partnership scheme. Obesity Facts. 2011; 4:(2)

van der Pligt P, Willcox J, Hesketh KD, Ball K, Wilkinson S, Crawford D, Campbell K Systematic review of lifestyle interventions to limit postpartum weight retention: implications for future opportunities to prevent maternal overweight and obesity following childbirth. Obesity Rev. 2013; 14:(10)792-805

Factors influencing engagement in postnatal weight management and weight and wellbeing outcomes

02 November 2016
Volume 24 · Issue 11



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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