Body Image and Pregnancy Weight Gain

Our society is so fixed on the ideal body type - skinny, fit, active, toned. No one wants to gain wait, to be “obese” based on their BMI, and there is so much focus on not gaining weight or only gaining appropriate amounts of weight that we can’t seem to discuss weight gain in pregnancy without someone leaving the conversation feeling inadequate. The recommendations for weight gain in pregnancy seem to change constantly, with diet recommendations changing almost as frequently. And it makes you wonder, does body image insecurity feed into pregnancy weight gain and what can happen because of it?

The social pressure to be thin and fit is far reaching. Even small children are picking up on this and wanting to be thinner. Weight Watchers even created a new program for kids, as if any child needs to be on a restrictive diet! Weight is such a tender topic, and so many are blaming the body positive movement for the rise in obesity, when there are many other factors at play. However, in pregnancy, weight gain should be the normal for every pregnant person, regardless of weight before pregnancy, and it can lead to a lot of heavy emotions and some people even end up diet restricting so they gain inadequately or not at all, and in some cases, even lose weight.

Even with that, this is the first time in many people’s lives that they are encouraged to gain weight, which is at odds with what they’ve been told their entire life. It can be hard to change your mindset around weight gain, even when you want to do everything possible to have a healthy pregnancy and healthy baby. A paper published by the WHO states, “During pregnancy and postpartum, women’s dissatisfaction with their bodies increases irrespective of how satisfied they were prior to the pregnancy. Evidence suggests that pregnant women who are affected negatively by changes to their body are less likely to initiate breastfeeding.” ¹ The breastfeeding aspect was a huge shock to me, I hadn’t thought of the connection to body image with the rates of breastfeeding or even just the initiation of breastfeeding. And the bit before that about stating that it didn’t matter how satisfied they were before pregnancy, the dissatisfaction with their body increased as pregnancy progressed.

A study published in 2009 about prepregnancy BMI, gestational weight gain, and likelihood of major depressive episodes discusses the impact of weight gain on incidences of depression during pregnancy.² Their findings weren’t very shocking, even with the body shaming attitude of obesity and BMI, and they showed that all sized people had an increased risk and chance of depression in pregnancy, though the risk was higher with those classified as “obese” before pregnancy. Interestingly enough though, those that were normal BMI before pregnancy had a much higher chance of depression if they had inadequate weight gain during their pregnancy. It almost feels like a doubled-edged sword - gain weight and it’s an issue, don’t gain weight and it’s an issue. I feel that the bigger issue isn’t how much or little is gained but the inner feelings around weight gain itself. Another paper published even discusses how weight stigma actually increases the chances of excessive weight gain, leading to higher rates of postpartum depression and weight retention.³ She wants communities and providers to focus more on how they’re treating pregnant people overall versus focusing on weight and all the factors that deals with.

And to turn it around a little bit, knowing how hard it is to be okay with weight gain in pregnancy and all that entails, I found an amazing post⁴ about some concrete ways you can feel a little more positive about your body during pregnancy. One of the big ones that I love to tell people is to get rid of the scale! You are not based on the number that shows up. You should be gaining weight, because your body is growing another human, expanding your blood volume, and creating a placenta, but weighing yourself regularly and at every appointment can be doing more harm than good to your mental health. And all this isn’t to say you won’t have bad days! “You’re going to have negative thoughts and feelings about your body sometimes so forget trying to be positive all the time. These thoughts are not a personal failure—we live in a culture that breeds body insecurity and bombards us with unrealistic beauty ideals daily.” One of their suggestions is to find positive sources instead, like the 4th Trimester Bodies Project.⁵

Just like any other time in your life, you are not defined by your weight. Pregnancy should be a time when you are eating well, growing healthy, building another human, not a time to focus on what the numbers mean or how our old clothes don’t fit anymore. Take it one day at a time and try to embrace the difference in your body. It’s not easy, but even small acts can help you feel better and have less depression and mental health issues than the focus on how your body is changing in a negative light.

Resources:

1. Breda, Joao. Body Image, Pregnancy, and Birth. http://www.euro.who.int/__data/assets/pdf_file/0003/277734/Body-image-and-pregnancy.pdf?ua=1

2. Bodnar, Lisa M. Prepregnancy Body Mass Index, Gestational Weight Gain, and the Likelihood of Major Depression During Pregnancy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2760651/

3.Rodriguez, Angela C. Association of Weight Discrimination During Pregnancy and Postpartum with Maternal Postpartum Health. https://medicalxpress.com/news/2019-02-pregnant-women-weight-stigma-decreased.html https://www.ncbi.nlm.nih.gov/pubmed/30762402

4. Davidson, Megan. 7 Steps for a Body Positive Pregnancy. https://www.nationaleatingdisorders.org/blog/steps-for-body-positive-pregnancy

5. The 4th Trimester Bodies Project. https://www.4thtrimesterbodiesproject.com/