Influences on the food choices and physical activity behaviours of overweight and obese pregnant women: A qualitative study

Objective: to qualitatively explore influences identified by overweight/obese pregnant women on food choices and physical activity (PA) behaviours; to determine the impact of pregnancy on these factors; and to inform development of future lifestyle interventions during pregnancy. Design: cross-sectional interview study. Setting: maternity hospital, Ireland. Participants: pregnant women (n=22), early pregnancy Body Mass Index > 25 kg/m(2) Measures: barriers to and facilitators of healthy eating and PA in overweight/obese pregnancy. Interviews were transcribed verbatim and analysed using inductive thematic analysis. Findings: overweight/obese women perceived the following factors to influence their food choices and PA behaviours: personal (e.g. age, enjoyment, health, aesthetic appearance, and response to fatigue); social (e.g. social support, food modelling, social facilitation and weight bias) and environmental (e.g. food salience and the obesogenic environment). These factors affected PA and food choice trajectories differently according to socioeconomic and socio-cultural context. Conclusion and Implications: personal, social and environmental factors affect food choices and PA behaviours. Pregnancy is a powerful stimulus for positive changes in food choices particularly. This change is driven by desire for healthy pregnancy outcome, and is not intrinsically motivated. Healthy lifestyle interventions should aim to sustain positive changes beyond pregnancy through: empowerment, intrinsic motivation, family-centred approach, and behavioural goals.