Body dysmorphia during pregnancy worsens self-image, quality of life

Key takeaways:

• Women with body dysmorphia during pregnancy had lower quality of life and body image.
• Women reported physical and psychological insecurities due to pregnancy, ranging from weight gain to appearance.

Body dysmorphic disorder may negatively impact quality of life and body image during pregnancy, especially during first and third trimesters, highlighting the need for interventions and support for pregnant women, researchers reported.

“Given that the concerns of pregnant women and the concerns of women with body dysmorphic disorder are similar in their nature, it is likely that pregnant women with body dysmorphic disorder symptoms may experience more difficulty adjusting to their rapidly changing bodies,” A. Hope Gibson, MA, graduate research assistant at the University of Texas Medical Branch, and colleagues wrote. “These women may also be more preoccupied with criticism from the people around them.”

Gibson and colleagues conducted a study, published in BMC Pregnancy and Childbirth, recruiting 158 U.S. women (median age, 30 years; 82.3% white) from expectant and new mothers’ Facebook groups, women’s centers across southern Texas and through Prolific between July 2021 and April 2022. All women completed the Body Image Disturbance Questionnaire (BIDQ), the Body Image Quality of Life Inventory and the Health-Related Quality of Life Scale online.

Overall, 15.8% of women were in the first, 32.9% in the second and 29.1% in the third trimester and 22.2% were 3 months postpartum.

Women with vs. without high body dysmorphic disorder had lower health-related quality of life and body image (P < .05 for both). Researchers observed a marginal effect of body dysmorphic disorder on pregnancy stage with a higher quality of life observed for women in second vs. first (P = .007) and third (P = .057) trimesters and postpartum (P = .037).

Physically, in the BIDQ, 31.01% of women reported concern with weight gain associated with pregnancy and postpartum. About 2.5% of women reported concerns about overweight prepregnancy and associated complications, which contributed to concerns about postpartum weight and appearance. Some women also reported specific physical concerns about “losing muscle tone/getting flabby” due to pregnancy. Physical changes due to pregnancy also contributed to reported discomfort with clothing and dressing.

Regarding psychological insecurities, 10.12% of women gave responses consistent with the belief that thinness is the “pinnacle of beauty.” About 4.5% of women reported concerns about wanting to appear pregnant and not overweight.

Specific areas of insecurity reported by participants included:

• upper body (23.41%);
• abdomen (29.75%);
• lower body (20.25%); and
• skin (34.17%).

Participants reported that these physical and psychological insecurities had an external and internal effect on their daily life. Most participants reported avoiding activities (51.9%) or specific clothing items (23.41%). In addition, participants also reported significant preoccupation with trouble choosing outfits (22.15%) and negative body image (34.81%) stemming from insecurities.

“Future researchers should continue examining the specific elements related to pregnant women’s quality of life, as well as explore how addressing those concerns and body dysmorphic disorder symptoms in general might contribute to better mental health during pregnancy and postpartum,” the researchers wrote.