Postpartum weight management

Nutrition Research Newsletter, August, 2004

Obesity has reached epidemic proportions in the United States, with no slowing in the incidence rate. The prevalence of obesity in women has tripled since the 1960s, with most of the increase occurring after 1980. Seven percent of women aged 20 to 34 years were obese in 1960 compared with 26% in 2000. One life event that explains some of women's weight gain is childbearing. Rooney and Schauberger reported that the mean weight gain from prepregnancy to 8.5 years follow-up was approximately 6 kg. Women who gained the least during long-term follow-up had lost most of their pregnancy weight by 6 months postpartum, had breast fed their children, and/or had participated in regular aerobic exercise. Thus, a critical time for weight-management interventions is the child bearing years, when weight retention or weight gain can be substantial. This study examined factors related to stages of change for weight-management behaviors in postpartum women.

Cross-sectional data, collected at baseline, are reported from the Mothers' Overweight Management Study (MOMS), a randomized, controlled trial conducted in postpartum women who participated in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The subjects were a sample of WIC recipients (N=151) older than 18 years of age with a child younger than 2 years. The dependent variables, that is, stages of change, were assessed for four weight-management behaviors: trying to lose weight, avoiding high-fat foods, eating a high-fiber diet, and exercising three times per week for 20 min each time. These behaviors were chosen because the researchers were interested in whether women at this phase of the life cycle were trying to lose weight.

Whereas 55% of women were in the action stage for weight loss, fewer women were in the action stage for the following weight management behaviors: avoiding high-fat foods (24%), increasing fiber (19%), and exercising three times per week (29%). Identifying pros for weight management was related to stages for losing weight, high-fat food avoidance, and exercise. Self-efficacy for choosing a low-fat restaurant meat or using food labels was positively related to later stages for avoiding high-fat foods and increasing fiber intake.

Emphasizing the pros for weight-management behaviors, decreasing the cons for exercising, increasing confidence to select low-fat restaurant choices, and improving skills for using food labels are four strategies that nutrition professionals can use to help women become mere ready to change behaviors for weight management.

D Krummel, E Semmens, J Boury, P Gordon, K Larkin. Stages of change for weight management in postpartum women, J Am Diet Assoc 104:1102-1108 (July 2004) [Correspondence: Debra A. Krummel, PhD, RD, Associate Professor, Community Medicine, West Virginia University School of Medicine, PO Box 9190, Morgantown, WV 26506 USA; Email: dkrummel@hsc.wvu.edu]