Women's Health Issues
Volume 20, Issue 2 , Pages 133-138, March 2010

Multiparity is Associated With High Motivation to Change Diet Among Overweight and Obese Postpartum Women

  • Lori A. Bastian, MD, MPH

      Affiliations

    • Department of Medicine, Duke University Medical Center, Durham, North Carolina
    • Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina
    • Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina
    • Corresponding Author InformationCorrespondence to: Lori A. Bastian, MD, MPH, DVAMC (152), 508 Fulton Street, Bldg 16, Rm 70, Durham, NC 27705; Phone: 919-668-2127; fax: 919-668-1300.
  • ,
  • Viranga C. Pathiraja, MD, MPH

      Affiliations

    • Department of Medicine, Duke University Medical Center, Durham, North Carolina
  • ,
  • Katrina Krause

      Affiliations

    • Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina
  • ,
  • Rebecca J. Namenek Brouwer

      Affiliations

    • Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina
  • ,
  • Geeta K. Swamy, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina
  • ,
  • Cheryl A. Lovelady, PhD, RD

      Affiliations

    • Department of Nutrition, University of North Carolina-Greensboro, Greensboro, North Carolina
  • ,
  • Truls Østbye, MD, PhD

      Affiliations

    • Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina
    • Duke-National University of Singapore Graduate Medical School, Singapore

Received 28 May 2009; received in revised form 5 November 2009; accepted 11 November 2009. published online 12 February 2010.

Background

Pregnancy is associated with weight gain and obesity. The aim of this study was to identify the effect of parity and other factors on motivation to change diet to lose weight in a cohort of overweight and obese postpartum women.

Study Design

Active Mothers Postpartum is a randomized, controlled trial aimed at postpartum weight reduction. At baseline, we measured motivation to change diet to lose weight among 491 overweight/obese postpartum women. Logistic regression was used to model the effect of parity on motivation to change diet at baseline while adjusting for potential confounders including age, race, education, body mass index category, and breastfeeding status.

Results

Approximately two thirds (68%) of participants were highly motivated to change their diet to lose weight. In the multivariable model, women with three or more children had 2.5 times the odds of high motivation compared with primigravid women, and women not breastfeeding had 1.6 times the odds of high motivation compared with any breastfeeding.

Conclusion

Although risk for obesity is incurred starting with a woman's first pregnancy, women in this study were more motivated to change their diet to lose weight after their third pregnancy. Further research is needed to understand how to best capitalize on the high motivation in women with several children as well as how to improve motivation for primigravid women and women who are breastfeeding.

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 Funded by the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health. Dr. Bastian had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Grant # DK 64986.

PII: S1049-3867(09)00138-8

doi:10.1016/j.whi.2009.11.005

Women's Health Issues
Volume 20, Issue 2 , Pages 133-138, March 2010