Academic journal article Journal of Family and Consumer Sciences

Women's Perception of Physicians' Influence of Weight Gain during Pregnancy

Academic journal article Journal of Family and Consumer Sciences

Women's Perception of Physicians' Influence of Weight Gain during Pregnancy

Article excerpt

SCHOLARSHIP

ABSTRACT

This investigation identified low-income pregnant womens perceptions of the influence of the physician as related to the subjects concerns about body image and weight gain during pregnancy. Survey data were used. The perceived influence of the physician regarding weight issues was greater for primiparas (p < 0.05), women who were limiting their weight gain (p < 0.05), or women with a higher body mass index (p < 0.05). However, most subjects (67%) strongly disagreed that the physician made them feel uncomfortable about their weight gain. Negative feelings toward weight gain during pregnancy did not appear to stem from the physician.

INTRODUCTION

A change in body image can occur during pregnancy that can be profound and unsettling for some women (Richardson, 1990; Flagler and Nicoll, 1990). Women assessed in the postpartum phase for perceptions about body image during pregnancy showed increasingly negative attitudes toward body image with the progression of pregnancy as well as body-size distortion with their postpartum body (Strang and Sullivan, 1985; Morin, 1995). Positive or negative perceptions of body changes may result relative to specific body parts during pregnancy (Fairburn and Welch, 1990). In a study of postpartum women, Abraham et al. found that many expected a smaller weight gain during pregnancy compared to their actual gain and that 76% of the sample had used weight control methods to inhibit gain (Abraham et al., 1994). Additionally, although most (94%) of the subjects in the Abraham et al., 1994 study felt positive toward having their weight checked, all subjects felt that pregnant women could respond to weight checks with negative behaviors such as thinking more about foods and weight (37 %) and modifying weight gain before the next doctor's visit by starving or water loading (13 %). Thus, pregnancy is associated with concerns about being overweight for some women. The impact of these concerns on pregnancy weight gain is unknown, but potentially significant.

Certain factors appear related to the development of negative attitudes toward body image during pregnancy. For example, primiparas have a more negative attitude toward their body image postpartum than multiparas (Strang and Sullivan, 1985). Furthermore, normal weight primiparas were more likely to experience negative body image changes during pregnancy, whereas overweight primiparas were more likely to experience positive body image changes (Fox and Yamaguchi, 1997). In addition, women with greater concerns about weight gain and weight control prior to pregnancy tend to be more concerned than others about these issues during pregnancy (Armstrong and Weijohn, 1991).

Low-income women enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are a priority group for assessment regarding weight gain issues as they are at higher risk than most women for negative pregnancy outcomes (Hickey, 2000). Furthermore, there is previous evidence of concerns about weight expressed by pregnant women in WIC, with the recommendation for further assessment of weight issues in this population (Armstrong and Weijohn, 1991).

The role that the physician plays in influencing weight gain and body image during pregnancy is also important, but understudied. Palmer et al. found that higher recommended weight gain from the physician was correlated with a higher actual weight gain in the pregnant subjects (Palmer et al., 1985). Also, the physician had a significant influence on women's attitudes toward pregnancy weight gain, but the direction of the influence was inconclusive (Palmer et al., 1985). Furthermore, Strychar et al. found that women with either excessive weight gain or insufficient weight gain were less likely than others to have spoken with a physician about their weight gain in the beginning of their pregnancy (Strychar et al., 2000). Additionally, women who had excessive or inadequate weight gain were also not knowledgeable about the risks associated with low or high weight gain during pregnancy (Strychar et al. …

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