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As I previously described, being pregnant and overweight is associated with increased risks of complications during pregnancy and childbirth. This is something that is carefully taught in both nursing and medical education. We learn that maternal obesity poses an increased risk for both the woman and the child.
Studies have also shown that children born to overweight women are at risk of becoming overweight, both in childhood and later in life. A pregnant woman with overweight also has a greater risk of developing conditions such as gestational diabetes (GDM), which in turn increases the risk of developing type 2 diabetes later in life, leading to complications. Later...
But what does the research say?
Many obese individuals often hear that it's simply "eat less and move more." But it's evidently not that simple. Pregnant women often hear from their midwives at antenatal care clinics, "You are overweight, you should watch what you eat, you're pregnant... think about the baby."
Contemporary research shows that obesity is caused by a number of complex and previously unknown interactions. It involves a demonstrated interplay between obesity-related genes and environmental factors. A project presented in 2003 unveiled the human genome, and since then, knowledge about the genetic basis of obesity has increased dramatically, although much remains to be learned.
The genetic influence on our body weight varies among individuals but is believed to contribute up to 70% of the risk of developing obesity. It involves aspects such as appetite regulation, metabolism, distribution of body fat, and BMI. There is also evidence of a genetic component that affects our food preferences and our response to different forms of exercise. We simply find different things tasty.
In the most common form of obesity, there is an interplay between genetics and an "obesogenic environment," meaning an environment with poor dietary habits and less physical activity. It's not a single factor that alone develops the risk of being overweight, but inheriting multiple obesity-related mutations can increase the risk of developing overweight and obesity, especially if one lives in an "obesogenic environment."
Weight bias and weight stigma
I have been reflecting a lot on how society handles women who are pregnant and also overweight. When we talk about overweight and weight-related issues, especially during pregnancy, two concepts often come up that are not directly related to medical care but rather our own and societal opinions: weight bias and weight stigma. It's important to try to understand and grasp the meaning of these words if we are to understand our own reactions when encountering overweight pregnant women or overweight individuals in our society in general.
Social etiquette
Is it okay to label people? The term weight bias refers to the negative assumptions, prejudices, and attitudes we have about people with overweight, particularly overweight women. These negative attitudes often lead to weight stigma, which means attaching a "social label" to a person based on their weight, for example.
Stigma originates from Greek and means mark or wound. It meant that the person in question was cut or burned to warn the public about them. Today, stigmatization occurs due to a person's body weight. Perhaps in a more subtle and different manner, but the underlying meaning remains the same.
We want to label these individuals in different ways. We secretly, if not publicly, think that these pregnant women have brought it upon themselves and that they are a bit more "lazy, careless, less intelligent, unsuccessful, lacking self-discipline, and have less self-control" compared to their normal-weight counterparts. Remember that, for instance, every 10th pregnant woman in Stockholm is overweight (BMI > 30). The stigma is the overweight itself, while the stigmatization consists of these "attributes" we give these women, with more or less negative characteristics/abilities.
Is obesity, a personal responsibility?
In today's society, it is generally believed that those living with obesity bear the majority of the responsibility for their overweight. They are obese by their own choice. When delving into the existing knowledge about the causes of obesity, it becomes clear that it's simply not that easy. My hope is that through the "Viktig project" for which I am responsible at SÖS, focusing on pregnant women with a BMI ≥ 35, we can change some of these thoughts.
Regarding other groups in society that are subjected to various forms of discrimination, such as people with different skin colors, religions, or disabilities, there is an ongoing open discussion condemning such acts of discrimination. However, when it comes to weight bias, it remains more or less acceptable to discriminate against a person based on their weight. Especially if the woman is pregnant. This is something we need to talk about and take to heart. Something we need to change.
Best regards,
Doctor Eva