1 Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada. tnagpal@ualberta.ca.
2 Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada. tnagpal@ualberta.ca.
3 Obesity Canada, Edmonton, AB, Canada.
4 Department of Family Medicine, Dalhousie University, Halifax, NS, Canada.
5 Department of Health, Kinesiology & Applied Physiology, Concordia University, Montreal, QC, Canada.
6 Department of Agricultural, Food and Nutritional Sciences, Faculty of ALES, University of Alberta, Edmonton, AB, Canada.
7 School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
8 Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada.
9 Department of Obstetrics and Gynecology, Queen's University, King

Background: Recent research has shown that pregnant individuals experience weight stigma throughout gestation, including negative comments and judgement associated with gestational weight gain (GWG). Weight bias internalization (WBI) is often a result of exposure to weight stigma and is detrimental to biopsychological health outcomes. The purpose of this study was to explore WBI in pregnancy and compare scores based on maternal weight-related factors including pre-pregnancy body mass index (BMI), obesity diagnosis and excessive GWG.

Methods: Pregnant individuals in Canada and USA completed a modified version of the Adult Weight Bias Internalization Scale. Self-reported pre-pregnancy height and weight were collected to calculate and classify pre-pregnancy BMI. Current weight was also reported to calculate GWG, which was then classified as excessive or not based on Institute of Medicine (2009) guidelines. Participants indicated if they were diagnosed with obesity by a healthcare provider. Inferential analyses were performed comparing WBI scores according to pre-pregnancy BMI, excessive GWG, and obesity diagnosis. Significance was accepted as p < 0.05 and effect sizes accompanied all analyses.

Result: 336 pregnant individuals completed the survey, with an average WBI score of 3.9 ± 1.2. WBI was higher among those who had a pre-pregnancy BMI of obese than normal weight (p = 0.04, ?² = 0.03), diagnosed with obesity than not diagnosed (p < 0.001, Cohen's d = 1.3), and gained excessively versus not (p < 0.001, Cohen's d = 1.2).

Conclusions: Pregnant individuals who have a higher BMI, obesity and gain excessively may experience WBI. Given that weight stigma frequently occurs in pregnancy, effective person-oriented strategies are needed to mitigate stigma and prevent and care for WBI.