Loss of control eating during pregnancy is associated with excessive gestational weight gain among individuals with overweight and obesity.

BACKGROUND: Excessive gestational weight gain (GWG) predicts negative health outcomes among individuals with overweight or obesity. Loss of control eating (LOC), the ingestion of food associated with being unable to control eating, is the core psychopathology of binge eating disorders. We evaluated the contribution of LOC to GWG among pregnant individuals with prepregnancy overweight/obesity. METHODS: In a prospective longitudinal study, individuals with prepregnancy BMI ≥ 25 (N = 257) were interviewed monthly to assess LOC and reported demographic, parity, and smoking information. GWG was abstracted from medical records. RESULTS: Among individuals with prepregnancy overweight/obesity, 39% endorsed LOC prior to or during pregnancy. After adjusting for factors that have previously been linked to GWG, LOC during pregnancy, uniquely predicted higher GWG and greater likelihood of exceeding GWG recommendations. Participants with prenatal LOC gained 3.14 kg (p = 0.03) more than did those without LOC during pregnancy and 78.7% (n = 48/61) exceeded IOM guidelines for GWG. The frequency of LOC episodes was also associated with greater weight gain. CONCLUSIONS: Prenatal LOC is common among pregnant individuals with overweight/obesity and predicts greater GWG and increased likelihood of exceeding IOM GWG guidelines. LOC may represent a modifiable behavioral mechanism to prevent excessive GWG among individuals at risk for adverse pregnancy outcomes.

Adapting the eating disorder examination for use during pregnancy: Preliminary results from a community sample of women with overweight and obesity.

OBJECTIVE: The Eating Disorder Examination (EDE) is a structured clinical interview that is widely used for assessing disordered eating. Although the EDE has been used in pregnant women, no standard pregnancy version has been developed. Accordingly, the present study aimed to document adaptations made to a pregnancy version of the EDE (EDE-PV) and to describe the internal reliability of this adapted version. METHOD: Three major modifications were made in the development of the EDE-PV. First, disordered eating was assessed during and prior to pregnancy to account for changes across the perinatal period. Second, items were adapted and rules governing ratings were altered to distinguish eating attitudes and behaviors that are considered normative during pregnancy from disordered eating. Third, several items were omitted. RESULTS: The EDE-PV was administered to 129 women with overweight and obesity who were between 12 and 20 weeks gestation. Women were 27.25 (SD = 5.48) years of age and 56% were African American. Women endorsed low levels of disordered eating on the EDE-PV, and the internal reliability was similar to previous reports. CONCLUSION: These findings provide support for use of the EDE-PV to assess disordered eating among pregnant women with overweight and obesity. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:597-601).

Prevalence and correlates of a lifetime cannabis use disorder among pregnant former tobacco smokers.

BACKGROUND: Following tobacco and alcohol, cannabis is the most commonly used substance during pregnancy. Given the high prevalence of concurrent cannabis and tobacco use as well as the health consequences associated with prenatal substance use, we sought to document the relative contributions of psychosocial and psychiatric factors commonly associated with cannabis use in predicting a lifetime cannabis use disorder (CUD) among women who had quit smoking tobacco as a result of pregnancy. METHODS: Pregnant former tobacco smokers (n=273) enrolled in a larger randomized controlled trial for postpartum tobacco relapse prevention completed semi-structured psychiatric interviews and self-reported demographic, pregnancy, health, psychosocial, and tobacco use factors during their third trimester of pregnancy. RESULTS: In total, 14% (n=38) of women met criteria for a lifetime CUD. The strongest predictors of a lifetime CUD were a history of having multiple psychiatric disorders (OR=36.44; 95% CI=5.03-264.27; p<0.001) followed by a lifetime alcohol use disorder (OR=3.54; 95% CI=1.27-9.87; p<0.05). In addition, more frequent attempts to quit smoking tobacco (OR=1.12; 95% CI=1.01-1.25; p<0.05) and lower self-efficacy about weight management after quitting smoking tobacco (OR=0.78; 95% CI=0.62-0.97; p<0.05) also were significantly associated with a lifetime CUD. CONCLUSIONS: Women with a history of both cannabis and tobacco dependence may represent a subset of women who need more specialized treatment during the perinatal period to improve substance use outcomes.