Association of eating behaviour with diet, body weight and psychological symptoms in pregnant women with overweight or obesity

Abstract

Eating behaviour may represent an important factor linking an unhealthy dietary intake and psychological symptoms to weight gain, but the phenomenon mediating this link during pregnancy has not been elucidated. Here, we differentiated eating behaviour profiles during pregnancy using the eating behaviour dimensions of the 18-item Three-Factor Eating Questionnaire (TFEQ-R18), cognitive restraint (CR), uncontrolled eating (UE) and emotional eating (EE) and investigated their associations with dietary intake, gestational weight gain, body composition and the level of depressive and anxiety symptoms. Furthermore, pregnant women with overweight or obesity ( n 434) completed three-day food diaries, the Index of Diet Quality questionnaire, the Edinburgh Postnatal Depression Scale and the anxiety subscale of the Symptom Checklist-90 in early and late pregnancy. Body composition was measured by air displacement plethysmography in early and late pregnancy. Confirmatory factor analysis was used to ensure the factor validity of the TFEQ-R18. Four distinct eating behaviour profiles were identified: Struggling (high CR), Susceptible (high EE), Rational (high CR, low UE and EE) and Easy-going (low CR, UE and EE). The women in the Susceptible group followed an unhealthier dietary pattern and had the highest fat mass and level of depressive and anxiety symptoms although their EE decreased the most during pregnancy. The findings imply that the Susceptible group appears especially predisposed to unfavourable health risks regarding diet, adiposity and psychological well-being. In health clinics, it might be beneficial to recognise those women with the highest likelihood of experiencing eating behaviour challenges in achieving dietary and weight management goals.