Abstract
BackgroundPregnancy is a time of high risk for excessive weight gain, leading to health-related consequences for mothers and offspring. Theory-based obesity interventions that target proposed mechanisms of biobehavioral change are needed, in addition to simply providing nutritional and weight gain directives. Mindfulness training is hypothesized to reduce stress and non-homeostatic eating behaviors – or eating for reasons other than hunger or caloric need. We developed a mindfulness-based intervention for high-risk, low-income overweight pregnant women over a series of iterative waves using the Obesity-Related Behavioral Intervention Trials (ORBIT) model of intervention development, and tested its effects on stress and eating behaviors.MethodsOverweight pregnant women (n = 110) in their second trimester were enrolled in an 8-week group intervention. Feasibility, acceptability, and facilitator fidelity were assessed, as well as stress, depression and eating behaviors before and after the intervention. We also examined whether pre-to-post intervention changes in outcomes of well-being and eating behaviors were associated with changes in proposed mechanisms of mindfulness, acceptance, and emotion regulation.ResultsParticipants attended a mean of 5.7 sessions (median = 7) out of 8 sessions total, and facilitator fidelity was very good. Of the women who completed class evaluations, at least half reported that each of the three class components (mindful breathing, mindful eating, and mindful movement) were “very useful,” and that they used them on most days at least once a day or more. Women improved in reported levels of mindfulness, acceptance, and emotion regulation, and these increases were correlated with reductions in stress, depression, and overeating.ConclusionsThese findings suggest that in pregnant women at high risk for excessive weight gain, it is both feasible and effective to use mindfulness strategies taught in a group format. Further, increases in certain mindfulness skills may help with better management of stress and overeating during pregnancy.Trial registrationClinicalTrials.gov NCT01307683, March 8, 2011.
Highlights
Pregnancy is a time of high risk for excessive weight gain, leading to health-related consequences for mothers and offspring
In this paper we describe a) our process model for intervention development; b) the content of the intervention resulting from this process; c) attendance, feasibility and teacher fidelity to the intervention; d) the intervention’s effects on proposed mechanisms of change; and e) whether these were related to well-being and non-homeostatic eating behaviors, focusing only on the participants who received the intervention
Pregnancy is a critical period for both maternal and offspring health, and there is need to reduce distress and unhealthy eating during pregnancy, for women at greatest risk for high stress and excessive gestational weight gain
Summary
Pregnancy is a time of high risk for excessive weight gain, leading to health-related consequences for mothers and offspring. We developed a mindfulness-based intervention for high-risk, low-income overweight pregnant women over a series of iterative waves using the Obesity-Related Behavioral Intervention Trials (ORBIT) model of intervention development, and tested its effects on stress and eating behaviors. Women who are already overweight or obese before pregnancy have greater risk for gestational weight gain greater than the recommended 15–25 pounds, or 11–20 pounds, respectively [3]. Both pre-pregnancy obesity and excessive maternal weight gain during pregnancy are associated with a number of unfavorable outcomes. Pregnancy may be a unique opportunity to positively influence a woman’s weight gain trajectory by offering low-cost, feasible, and effective interventions that could reduce health risks for both mother and child
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