# Presentation of a weight bias internalization tool for use in pregnancy and a call for future research: A commentary

## TL;DR

This paper introduces a new tool to measure weight bias internalization during pregnancy and suggests future research to improve prenatal care and outcomes.

## Contribution

A pregnancy-specific weight bias internalization tool incorporating gestational weight gain is proposed.

## Key findings

- Weight stigma during pregnancy may lead to internalized weight bias.
- A modified WBI tool accounting for gestational weight gain is presented.
- Future validation and research on maternal and newborn outcomes are recommended.

## Abstract

Emerging evidence has shown that weight stigma is a concern during pregnancy, with several studies documenting common sources including healthcare, the media and interpersonal networks. Experiencing weight stigma may lead to weight bias internalization (WBI), whereby individuals accept and self-direct negative weight-related stereotypes, and limited research has assessed this in the context of pregnancy. Pregnancy is unique in terms of weight changes as many individuals will experience gestational weight gain (GWG). Accordingly, a WBI tool that accounts for GWG may be a more population-specific resource to use.

This commentary presents a pregnancy-specific WBI tool that accounts for GWG. The validated Adult WBI scale was modified to include ‘pregnancy weight gain’. This commentary also presents a brief summary of research that has assessed WBI in pregnancy and recommendations for future work.

Recommended future work includes validation of the pregnancy-specific WBI tool and prospective examinations of weight stigma and WBI in pregnancy and implications on maternal and newborn outcomes.

Ultimately this research may inform development of interventions and resources to mitigate weight stigma and WBI in pregnancy and overall may contribute to improving prenatal outcomes and experiences.