Skip to main content Accessibility help
Hostname: page-component-99c86f546-swqlm Total loading time: 0.384 Render date: 2021-11-28T18:43:39.980Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

7 - Obesity in pregnancy and mental health

from Section 2 - Pregnancy outcome

Published online by Cambridge University Press:  05 August 2012

Matthew W. Gillman
Harvard Medical School
Lucilla Poston
King's College London
Get access



There is increasing recognition internationally that the physical health of people is only possible if they are also mentally healthy [1]; this is even more pertinent in pregnancy where a mother’s mental health can impact not only on her physical health but also the health of her baby in utero [2]. Obesity and mental health problems are both important causes of maternal deaths in the UK and other industrialized countries [3–5]. This chapter therefore aims to review the evidence on how obesity in pregnancy is related to mental disorders and the implications of this for the management of obesity in pregnancy.

The mental disorders we will focus on are often grouped together as severe mental illness, common mental disorders, and binge eating disorder (other eating disorders and learning difficulties are beyond the scope of this chapter). The main international classifications of mental disorders are the World Health Organization (WHO) ICD classification [6] and the American Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) [7], both of which are currently being revised and updated (ICD-11 and DSM-V will be appearing in the next few years). We will use the current definitions in ICD-10 predominantly, other than for binge eating disorder, which is only included in the DSM classification currently (see also below).

Maternal Obesity , pp. 70 - 80
Publisher: Cambridge University Press
Print publication year: 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Prince, M Patel, V Saxena, S No health without mental health Lancet 2007 370 859 Google Scholar
Howard, L M Fertility and pregnancy in women with psychotic disorders Eur J Obstet Gynecol Reprod Biol 2005 119 3 Google Scholar
Kildea, S Pollock, W E Barclay, L. Making pregnancy safer in Australia: the importance of maternal death review Aust N Z J Obstet Gynaecol 2008 48 130 Google Scholar
Schutte, J M Hink, E Heres M, H Maternal mortality due to psychiatric disorders in the Netherlands J Psychosom Obstet Gynaecol 2008 29 150 Google Scholar
Cantwell, R Clutton-Brock, T Cooper, G Saving Mothers’ Lives: reviewing maternal deaths to make motherhood safer: 2006–2008. The eight report of the Confidential Enquiries into Maternal Deaths in the United Kingdom BJOG 2011 118 1 Google Scholar
WHO International Classification of Diseases and Related Health Problems, 10th Revision 2010
American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition American Psychiatric Association 2000
Treasure, J Claudino, A M Zucker, N. Eating disorders Lancet 2010 375 583 Google Scholar
Vesga-Lopez, O Bianco, C Keyes, K Psychiatric disorders in pregnant and postpartum women in the United States Arch Gen Psychiatry 2008 65 805 Google Scholar
Gavin, N I Gaynes, B N Lohr, K N Perinatal depression: a systematic review of prevalence and incidence Obstet Gynecol 2005 106 1071 Google Scholar
Bick, D Howard, L M When should women be screened for postnatal depression? Expert Rev Neurother 2010 10 151 Google Scholar
Cox, J L Holden, J M Sagovsky, R Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale Br J Psychiatry 1987 150 782 Google Scholar
Gibson, J McKenzie-McHarg, K Shakespeare, J A systematic review of studies validating the Edinburgh Postnatal Depression Scale in antepartum and postpartum women Acta Psychiatr Scand 2009 119 350 Google Scholar
National Institute for Health and Clinical Excellence 2007
Leight, K L Fitelson, E M Weston, C A Childbirth and mental disorders Int Rev Psychiatry 2010 22 453 Google Scholar
Sutter Dallay, A L Giaconne-Marcesche, V Glatigny-Dallay, E Women with anxiety disorders during pregnancy are at increased risk of intense postnatal depressive symptoms: a prospective survey of the MATQUID cohort Eur Psychiatry 2004 19 459 Google Scholar
Cohen, L S Altshuler, L L Harlow, B L Relapse of major depression during pregnancy in women who maintain or discontinue antidepressant treatment JAMA 2006 295 499 Google Scholar
Bulik, C M Von Holle, A Hamer, R Patterns of remission, continuation and incidence of broadly defined eating disorders during early pregnancy in the Norwegian Mother and Child Cohort Study (MoBa) Psychol Med 2007 37 1109 Google Scholar
Viguera, A C Whitfield, T Baldessarini, R J Risk of recurrence in women with bipolar disorder during pregnancy: prospective study of mood stabilizer discontinuation Am J Psychiatry 2007 164 1817 Google Scholar
Munk-Olsen, T Laursen, T M Pedersen, C B New parents and mental disorders: a population-based register study JAMA 2006 296 2582 Google Scholar
Ferrari, A J Baxter, A J Whiteford, H A A systematic review of the global distribution and availability of prevalence data for bipolar disorder J Affect Disord 2011 134 1 Google Scholar
McGrath, J Saha, S Chant, D Schizophrenia: a concise overview of incidence, prevalence, and mortality Epidemiol Rev 2008 30 67 Google Scholar
Howard, L M Kumar, C Leese, M The general fertility rate in women with psychotic disorders Am J Psychiatry 2002 159 991 Google Scholar
Webb, R Abel, K Pickles, A Mortality in offspring of parents with psychotic disorders: a critical review and meta-analysis Am J Psychiatry 2005 162 1045 Google Scholar
Howard, L M Goss, C Leese, M Medical outcome of pregnancy in women with psychotic disorders and their infants in the first year after birth Br J Psychiatry 2003 182 63 Google Scholar
Grote, N K Bridge, J A Gavin, A R A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight and intrauterine growth restriction Arch Gen Psychiatry 2010 67 1012 Google Scholar
Howard, L M Kirkwood, D Latinovic, R. Sudden infant death syndrome and maternal depression J Clin Psychiatry 2007 68 1279 Google Scholar
Alder, J Fink, N Bitzer, J Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature J Matern Fetal Neonatal Med 2007 20 189 Google Scholar
Bulik, C M Von Holle, A Siega-Riz, A M Birth outcomes in women with eating disorders in the Norwegian Mother and Child Cohort Study Int J Eat Disord 2009 42 9 Google Scholar
Goodwin, R D Keyes, K Simuro, N. Mental disorders and nicotine dependence among pregnant women in the United States Obstet Gynecol 2007 109 875 Google Scholar
Newham, J J Thomas, S H MacRitchie, K Birth weight of infants after maternal exposure to typical and atypical antipsychotics: prospective comparison study Br J Psychiatry 2008 192 333 Google Scholar
Reis, M Källén, B Maternal use of antipsychotics in early pregnancy and delivery outcome J Clin Psychopharmacol 2008 28 279 Google Scholar
Milgrom, J Skouteris, H Worotniuk, T 2012
Bodnar, L M Wisner, K L Moses-Kolko, E Prepregnancy body mass index, gestational weight gain and the likelihood of major depression during pregnancy J Clin Psychol 2009 70 1290 Google Scholar
Allison, D B Newcomer, J W Dunn, A L Obesity among those with mental disorders. A National Institute of Mental Health Meeting Report Am J Prev Med 2009 36 341 Google Scholar
Dickerson, F B Brown, C H Kreyenbuhl, J A Obesity among individuals with serious mental illness Acta Psychiatr Scand 2006 113 306 Google Scholar
Hakko, H Komulainen, M T Koponen, H Are females at special risk of obesity if they become psychotic? The Longitudinal Northern Finland 1966 Birth Cohort Study Schizophr Res 2006 84 15 Google Scholar
De Hert, M Dekker, J M Wood, D Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC) Eur Psychiatry 2009 24 412 Google Scholar
Holt R, I Peveler, R C Obesity, serious mental illness and antipsychotic drugs Diabetes Obes Metab 2009 11 665 Google Scholar
Allison, D B Mentore, J L Heo, M Antipsychotic-induced weight gain: a comprehensive research synthesis Am J Psychiatry 1999 156 1686 Google Scholar
De Hert, M A van Winkel, R Van Eyck, D Prevalence of the metabolic syndrome in patients with schizophrenia treated with antipsychotic medication Schizophr Res 2006 83 87 Google Scholar
Hippisley-Cox, J Parker, C Coupland, C Inequalities in the primary care of patients with coronary heart disease and serious mental health problems: a cross-sectional study Heart 2007 93 1256 Google Scholar
Druss, B G Bradford, W D Rosenheck, R A Quality of medical care and excess mortality in older patients with mental disorders Arch Gen Psychiatry 2001 58 565 Google Scholar
Mackin, P Bishop, D R Watkinson, H M A prospective study of monitoring practices for metabolic disease in antipsychotic-treated community psychiatric patients BMC Psychiatry 2007 7 28 Google Scholar
Osborn, D P King, M B Nazareth, I Participation in screening for cardiovascular risk by people with schizophrenia or similar mental illnesses: cross sectional study in general practice BMJ 2003 326 1122 Google Scholar
Howard, L M Barley, E Rigg, A A diagnosis of cancer in people with severe mental illness: practical and ethical issues raised Lancet Oncol 2010 11 797 Google Scholar
McEvoy, J P Meyer, J M Goff, D C Prevalence of the metabolic syndrome in patients with schizophrenia: baseline results from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial and comparison with national estimates from NHANES III Schizophr Res 2005 80 19 Google Scholar
National Institute for Health and Clinical Excellence 2009
Fagiolini, A Kupter, D J Houck, PR Obesity as a correlate of outcome in patients with bipolar I disorder Am J Psychiatry 2003 160 112 Google Scholar
Torrent, C Amann, B Sánchez-Moreno, J Weight gain in bipolar disorder: pharmacological treatment as a contributing factor Acta Psychiatr Scand 2008 118 4 Google Scholar
Diflorio, A Jones, I Is sex important? Gender differences in bipolar disorder Int Rev Psychiatry 2010 22 437 Google Scholar
Luppino, F S de Wit, L M Bouvy, P F Overweight, obesity, and depression. A systematic review and meta-analysis of longitudinal studies Arch Gen Psychiatry 2010 67 220 Google Scholar
Gariepy, G Wang, J L Lesage, A D The longitudinal association from obesity to depression: results from the 12-year National Population Health Survey Obesity 2010 18 1033 Google Scholar
Patten, S B Williams J, V Lavorato, D H Major depression, antidepressant medication and the risk of obesity Psychother Psychosom 2009 78 182 Google Scholar
Uher, R Mors, O Hauser, J Body weight as a predictor of antidepressant efficacy in the GENDEP project J Affect Disord 2009 118 147 Google Scholar
Gariepy, G Nitka, D Schmitz, N The association between obesity and anxiety disorders in the population: a systematic review and meta-analysis Int J Obes 2010 34 407 Google Scholar
Tuthill, A Slawik, H O’Rahilly, S Psychiatric co-morbidities in patients attending specialist obesity services in the UK Q J Med 2006 99 317 Google Scholar
Azarbad, L Corsica, J Hall, B Psychosocial correlates of Binge Eating Disorder in Hispanic, African American, and Caucasian women presenting for bariatric surgery Eat Behav 2010 11 79 Google Scholar
Fandiño, J Moreira, R O Preissler, C Impact of Binge Eating Disorder in the psychopathological profile of obese women Compr Psychiatry 2010 51 110 Google Scholar
Riener, R Schindler, K Ludvik, B Psychosocial variables, eating behaviour, depression, and binge eating in morbidly obese subjects Eat Behav 2006 7 309 Google Scholar
Dingemans, A E Bruna, M J van Furth, E F Binge Eating Disorder: a review Int J Obes 2002 26 299 Google Scholar
Reichborn-Kjennerud, T Bulik, C M Sullivan, P F Psychiatric and medical symptoms in binge eating in the absence of compensatory behaviours Obes Res 2004 12 1445 Google Scholar
Grenon, R Tasca, G A Cwinn, E Depressive symptoms are associated with medication use and lower health-related quality of life in overweight women with Binge Eating Disorder Womens Health Issues 2010 20 435 Google Scholar
Keck, P E McElroy, S L Bipolar disorder, obesity, and pharmacotherapy-associated weight gain J Clin Psychiatry 2003 64 1426 Google Scholar
Faulkner, G Cohn, T Remington, G Interventions to reduce weight gain in schizophrenia Cochrane Database Syst Rev 2007 1 Google Scholar
Beebe, L H Smith, K Burk, R Effect of a motivational intervention on exercise behaviour in persons with schizophrenia spectrum disorders Community Ment Health J 2011 47 628 Google Scholar
Chen, C K Chen, Y C Huang, Y S Effects of a 10-week weight control program on obese patients with schizophrenia or schizoaffective disorder: a 12-month follow up Psychiatry Clin Neurosci 2009 63 17 Google Scholar
Ussher, M Stanbury, L Cheeseman, V Physical activity preferences and perceived barriers to activity among persons with severe mental illness in the United Kingdom Psychiatr Serv 2007 58 405 Google Scholar
Wilfley, D E Welch, R R Stein, R I A randomized comparison of group cognitive-behavioral therapy and group interpersonal psychotherapy for the treatment of overweight individuals with binge-eating disorder Arch Gen Psychiatry 2002 59 713 Google Scholar
Bulik, C M Brownley, K A Shapiro, J R Diagnosis and management of Binge Eating Disorder World Psychiatry 2007 6 142 Google Scholar
Pagoto, S Bodenlos, J S Kantor, L Association of major depression and Binge Eating Disorder with weight loss in a clinical setting Obesity 2007 15 2557 Google Scholar
Krogh, J Nordentoft, M Sterne, J A The effect of exercise in clinically depressed adults: systematic review and meta-analysis of randomized controlled trials J Clin Psychiatry 2011 72 529 Google Scholar
Daley, A Jolly, K MacArthur, C. The effectiveness of exercise in the management of post-natal depression: systematic review and meta-analysis Fam Pract 2009 26 154 Google Scholar
Howard, L M Webb, R Abel, K. Antipsychotic drugs for pregnant and breastfeeding women with non-affective psychosis BMJ 2004 329 933 Google Scholar
Taylor, D Paton, C Kapur, S The Maudsley Prescribing Guidelines London Informa Healthcare 2009
Cited by

Send book to Kindle

To send this book to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats

Send book to Dropbox

To send content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox.

Available formats

Send book to Google Drive

To send content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive.

Available formats