Development and delivery of a habit-based lifestyle intervention to pregnant women with overweight or obesity

  • Julia McClelland

Student thesis: Doctoral ThesisDoctor of Philosophy


The prevalence of obesity has increased worldwide in recent decades. So too has weight-related discrimination and weight bias, leading to obesity stigma. In the United Kingdom, approximately 50% of pregnant women have overweight or obesity by the time they attend their first main antenatal appointment. These women are more likely to gain excessive weight during pregnancy which is associated with an increased risk of health complications for mother and baby. The aim of this thesis was to develop and deliver a habit-based lifestyle intervention, based on the Ten Top Tips for a Healthy Weight (10TT) intervention, to improve nutrition and physical activity behaviours and to help pregnant women with overweight and obesity to manage their weight, and to assess the feasibility and acceptability of the intervention. This PhD involved: 1) creating a questionnaire to explore people’s experiences of having excess weight, gain an understanding of the level of weight bias in the UK and Ireland, and to determine if certain terminology to describe weight is preferred in different contexts; 2) conducting a rapid review to identify key components of successful gestational weight gain interventions; 3) developing a habit-based intervention (the Healthy Habits in Pregnancy and Beyond intervention, HHIPBe), and an enhanced version of the intervention (HHIPBe+), for pregnant women with a body mass index between 25 and 38kg/m2; and 4) assessing the feasibility and acceptability of the HHIPBe+ intervention in a single arm, non-randomised feasibility study for pregnant women. Responses to the questionnaire indicated that weight stigma is prevalent in society and highlights that people can be stigmatised in nearly every aspect of life. There is work to be done in all areas of society to address these issues and make society a more inclusive place for all, regardless of body size. The HHIPBe+ feasibility study was found to be acceptable to pregnant women and provides valuable information for future studies.

Thesis embargoed until 31 July 2024.
Date of AwardJul 2022
Original languageEnglish
Awarding Institution
  • Queen's University Belfast
SponsorsCross-border Healthcare Intervention Trials In Ireland Network (CHITIN)
SupervisorMichelle McKinley (Supervisor), Laura McGowan (Supervisor) & Dunla Gallagher (Supervisor)


  • Pregnancy
  • obesity
  • weight stigma
  • healthy lifestyle intervention
  • habit formation
  • intervention development

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