(PS6-A5) Preconception Weight Suppression Predicts Eating Disorder Symptoms in Pregnancy

The age ranges for the typical development of eating disorders and for reproductive function overlap in disordered eating, in particular, binge eating is common in pregnant individuals. Disordered eating, is associated with increased risk of excess gestational weight gain (GWG) and adverse outcomes during the perinatal period, including higher rates of miscarriage, premature labor, intrauterine growth restriction, and small for gestational age and low birthweight. Weight suppression (WS), the discrepancy between highest lifetime and current weight, is a robust predictor of loss of control (LOC), binge eating, and weight gain trajectories in clinical populations, with growing evidence for an association with maladaptive eating behaviors in non-clinical samples. This study explored the potential role of preconception WS (i.e., the discrepancy between highest lifetime weight and weight before the onset of pregnancy) as a predictor of disordered eating and weight gain in pregnancy. Pregnant individuals (n=137) reported their highest preconception weight and current weight to calculate preconception WS, actual GWG, and deviations from recommended weight gain trajectories at the current stage of gestation. Participants also completed the Prenatal Eating Behaviors Screening (PEBS) tool, a validated measure of disordered eating specifically in pregnancy (Cronbach’s α in the present sample = .80). Most respondents (82.0%, n = 109) endorsed some level of preconception WS (M = 16.98 lbs, SD = 23.67), and about half (48.5%, n = 63) reported GWG exceeding recommendations for their stage of gestation at the time of survey completion. Eating disorder severity was moderate in this sample; 26.2% (n = 38) of respondents endorsed at least “occasional” LOC eating; 20.0% (n = 29) reported “occasional” or more frequent binge eating. Preconception WS was significantly positively correlated with pre-pregnancy body mass index (BMI) (r=.25, p=.004) but unrelated to actual or insufficient/excess GWG. Preconception WS was a significant predictor of PEBS total scores [F(5, 122) = 2.70, p=.02, R2=.10] and significantly positively correlated with individual item scores quantifying restrictive eating behaviors such as avoidance of liked foods and restriction of portion sizes (both p< .05). Preconception WS was not predictive of deviations from recommended GWG trajectories, LOC, or binge eating frequency and did not interact with pre-pregnancy BMI or GWG to predict eating disorder symptom severity. Our findings suggest that preconception WS is associated with a somewhat elevated risk of restrictive eating behaviors in pregnant individuals. Assessment of WS could easily be incorporated into routine perinatal screenings to identify pregnant individuals potentially at risk for disordered eating. More work is needed to identify additional factors that account for a more substantial amount of the variance in disordered eating during pregnancy.