title: Women's Perceived Reasons for Their Excessive Postpartum Weight Retention: A Qualitative Interview Study.
abstract: BACKGROUND
  Obesity in Sweden has doubled to 14% over the last 20 years. New strategies for treatment and prevention are needed. Excessive gestational weight gain has been found to contribute substantially to obesity, and there is a consistent association between postpartum weight retention and obesity later in life. We aimed to explore what factors women perceive as reasons for having substantial postpartum weight retention, to identify areas for new and improved interventions.
  
  
  METHODS
  Qualitative interview study (semi-structured) using an emergent design. Fifteen women, with a postpartum weight retention ≥ 10 kg, were interviewed by a trained cognitive therapist. Eight women had pre-pregnancy BMI below 30 kg/m2. Interviews were transcribed verbatim and data analysed using inductive manifest content analysis. Salient text passages were extracted, shortened, coded and clustered into categories.
  
  
  RESULTS
  Participants reported no knowledge of current gestational weight gain recommendations or of risks for adverse pregnancy outcomes with excessive weight gain or postpartum weight retention. Excessive eating emerged as a common strategy to provide relief of psychological, emotional and physical discomfort, such as depression and morning sickness. Women perceived medical staff as being unconcerned about weight, and postpartum weight loss support was scarce or absent. Some women reported eating more due to a belief that breastfeeding would automatically lead to weight loss.
  
  
  CONCLUSIONS
  There is a need to raise awareness about risks with unhealthy gestational weight development and postpartum weight retention in women of childbearing age. The common strategy to cope with psychological, emotional or physical discomfort by eating is an important factor to target with intervention. The postpartum year is a neglected period where additional follow-up on weight and weight loss support is strongly indicated.
authors.affiliation: Obesity Center, Karolinska University Hospital, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Anne
authors.initials: A
authors.lastname: Christenson
authors.affiliation: Department of Public Health Sciences (IHCAR), Karolinska Institutet, Stockholm, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Johansson
authors.affiliation: Obesity Center, Karolinska University Hospital, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Signy
authors.initials: S
authors.lastname: Reynisdottir
authors.affiliation: Department of molecular and clinical medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
authors.forename: Jarl
authors.initials: J
authors.lastname: Torgerson
authors.affiliation: Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Erik
authors.initials: E
authors.lastname: Hemmingsson
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001942:Breast Feeding; D003863:Depression / Q000150:complications; D005247:Feeding Behavior; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D048968:Morning Sickness / Q000150:complications; D009765:Obesity / Q000453:epidemiology*; D049590:Postpartum Period; D011247:Pregnancy; D036301:Qualitative Research; D013315:Stress, Psychological / Q000150:complications; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D015430:Weight Gain; D055815:Young Adult