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The Damaging Effect of Commenting on Pregnant Women’s Bodies

New research finds weight stigma is linked to depression in pregnant women.

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Pregnancy can bring a host of new challenges when it comes to maintaining a healthy body image. Even though gaining weight during pregnancy is necessary for the health of the baby, that weight gain often increases women’s dissatisfaction with their bodies. Given how obsessed our culture is with thinness and dieting, perhaps this isn’t surprising. Gaining weight for any reason can lead to judgment, ridicule, and other stigmatizing experiences, especially for women. New research published in the journal Social Science and Medicine finds that the majority of pregnant and postpartum women experience this type of weight-related stigma. This stigma is associated with a variety of negative physical and mental health outcomes.

Researchers surveyed pregnant women in their second or third trimester along with women who had given birth in the past year. All women answered a key question: “Since becoming pregnant, have you ever been treated differently because of your weight or has something or someone made you feel bad or uncomfortable because of your weight?” Well over half of the women (65%) said they had experienced this type of stigma. Researchers then asked these women about the source of the stigma. Options included work, family, friends, faith community members, partners, healthcare providers, strangers, the media, other mothers, and society in general. The women also completed surveys measuring eating behaviors and levels of depression.

Women who experienced weight-related stigma when they were pregnant or postpartum listed “society in general” as the most common source of the stigma. However, many also reported experiencing stigma from other sources, including the media (25%), strangers (21%), family members (21%), healthcare providers (18%), and other mothers, friends, or work (all 14% each).

These results are consistent with other recently published research that examined the content of weight stigmatizing comments pregnant women received. In that study, women shared a variety of insulting comments they heard from both friends and strangers. For example, one woman told researchers that a stranger told her she was “too fat to be pregnant.” Another was told by an acquaintance at her church that she should put her baby up for adoption because she was “going to make it fat.” A different woman told researchers her partner would grab her stomach and ask “when it was going to go back to normal.” Even the doctors providing healthcare to these women made stigmatizing comments. One doctor suggested that his patient should consider whether she wanted “a vaginal delivery or a donut.”

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These types of experiences can have significant consequences for pregnant women’s mental and physical health. In the first study mentioned above, researchers found that the more sources of weight discrimination a woman experienced, the more symptoms of depression she reported and the more maladaptive dieting behaviors and emotional eating she engaged in. Experiencing this type of weight stigma was also significantly associated with how much stress the women reported experiencing. It’s important to note that the results held up even when controlling for women’s body size. In other words, no matter how much weight a woman gained as a result of her pregnancy and no matter what her BMI was before she became pregnant, weight-stigmatizing experiences significantly predicted depression, stress, and maladaptive eating behaviors.

It is possible that some people (particularly healthcare providers) make stigmatizing comments about pregnant women’s weight because they are concerned about the health impacts of excessive weight gain during pregnancy. However, over a decade’s worth of scientific findings demonstrate that shaming people for their weight does not promote weight loss. In fact, research links experiencing weight stigma to weight gain. Being the target of weight-related stigma is also associated with depression, particularly among women, and with a variety of negative physical health outcomes.

Pregnancy can be a stressful time for many women. By the second trimester, a pregnancy tends to be publicly visible, which seems to have the odd effect of making people feel that the shape and size of a pregnant woman’s body is an appropriate topic of discussion.

The results of this research make one thing clear: The best advice for people who feel the need to comment on a pregnant (or postpartum) woman’s body size is don’t.

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