Prenatal Body Image: Association with Disordered Eating Behaviors and Depressive Symptoms Across Pregnancy

Abstract

Background: Disordered eating behaviors and depressive symptoms can be problematic during pregnancy for both the individual and their offspring. Our study aimed to determine the extent to which body image dissatisfaction early in pregnancy predicts eating disorder behaviors and/or depressive symptoms across pregnancy. Methods: Participants (N = 253) completed self-report assessments of depressive and eating disorder symptoms alongside the modified Body Image in Pregnancy Scale in their first, second, and third trimesters. Latent trajectory modeling was used to examine eating disorder behaviors and depressive symptoms across time. Results: Latent trajectory modeling demonstrated that body image—namely, Preoccupation with Body Size, Preoccupation with Attractiveness, and Dissatisfaction with Strength, Tone, and Flexibility—significantly predicted both disordered eating and depressive symptoms in the third trimester, even when controlling for body mass index, eating pathology symptoms, and depressive symptoms in the first trimester. Change in Dissatisfaction with Strength, Tone, and Flexibility across pregnancy also significantly predicted third-trimester disordered eating (b = 0.41, standard error [SE] = 0.12, p < 0.001) and depressive symptoms (b = 0.40, SE = 0.12, p = 0.001). Conclusions: Although depressive symptoms are often assessed during prenatal care, disordered eating behaviors during pregnancy are often missed. While it is unknown how many participants met criteria for an eating disorder or major depressive disorder given only self-report measures were utilized rather than clinical interviews, this study suggests that assessing body image concerns early during the first trimester could help to identify individuals who may benefit from psychological treatment during pregnancy.