Determinants of Weight Loss after an Intervention in Low-Income Women in Early Postpartum

Abstract

Objective: Postpartum is a critical period for the development of obesity in women, yet there is limited research of factors associated with changes in weight during early postpartum. Therefore, the objective of this study was to identify determinants of weight loss after an intervention.Methods: A sample of women in early postpartum was recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children clinics, doctors' offices, and neighborhood centers (N = 58). Women participated in an 8-week weight-loss intervention. Subjects were measured for weight and height and completed demographics, the Eating Stimulus Index, a nutrition knowledge test, a food-frequency questionnaire, and a household environment survey. Correlations and linear regression determined associations with the outcome variable weight loss, and hierarchical regression was used to determine the most significant predictors.Results: All subjects improved their nutrition knowledge, skills, convenience-eating resistance, and fruit and vegetable availability after the intervention. Responders had greater changes in dietary restraint, fruit juice servings, and discretionary energy than did nonresponders. Increases in dietary restraint, weight-management skills, and weight-loss self-efficacy and decreases in discretionary energy intake significantly predicted weight loss in individual regression analysis. After hierarchical regression analysis, improvement in dietary restraint was the most significant determinant, followed by decreases in total energy intake. Although weight-loss self-efficacy, weight-management skills, and discretionary energy intake significantly predicted weight loss when analyzed alone, these variables did not contribute to the prediction model revealed by this study.Conclusions: Positive changes in social cognitive theory constructs are associated with weight loss in low-income postpartum women. Dietary restraint, weight-management skills, weight loss self-efficacy, and reductions in total and discretionary energy are modifiable factors that should be emphasized in interventions designed for this population, but only dietary restraint and total energy intake were predicted in the model.