Table 3 Panel ratings for the potential symptom attributes of disordered eating in pregnancy

 Dietary consumption that does not support a healthy pregnancy

P

4.88 (.33)

5.00

100%

Yes

C

4.67 (1.05)

5.00

93.3%

Yes

 Dieting behaviours (e.g., calorie counting)

P

4.15 (.68)

4.00

92.3%

Yes

C

4.13 (1.41)

5.00

80.0%

Yes

 Inflexibility and rigidity with diet (i.e., strict consumption of diet foods only)

P

4.88 (.33)

5.00

100%

Yes

C

4.07 (1.03)

4.00

86.7%

Yes

 Fasting and/or skipping meals

P

4.88 (.33)

5.00

100%

Yes

C

4.53 (1.06)

5.00

93.3%

Yes

 Use of meal replacements (when not advised by a health professional)

P

4.54 (.81)

5.00

88.5%

Yes

C

4.40 (1.40)

5.00

86.7%

Yes

 Repeated weighing

P

3.85 (.78)

4.00

76.9%

Yes

C

4.67 (1.05)

5.00

93.3%

Yes

 Refusing to eat outside of one’s home

P

4.65 (.56)

5.00

96.2%

Yes

C

4.33 (1.23)

5.00

86.7%

Yes

 Eating in secret

P

4.73 (.45)

5.00

100%

Yes

C

4.60 (1.06)

5.00

93.3%

Yes

 Eating an objectively large amount of food

P

3.85 (.54)

4.00

76.9%

Yes

C

3.93 (1.03)

4.00

80.0%

Yes

 Eating for “two”

P

2.46 (.76)

2.00

7.7%

No

C

3.33 (.72)

3.00

33.3%

No

 Eating when not physically hungry

P

3.08 (.56)

3.00

19.2%

No

C

4.13 (.52)

4.00

93.3%

Yes

 Using food to cope with/soothe strong emotions, or reward oneself

P

3.92 (.63)

4.00

84.6%

Yes

C

4.07 (1.10)

4.00

80.0%

Yes

 Eating rapidly and until uncomfortably full

P

4.31 (.62)

4.00

92.3%

Yes

C

4.13 (1.13)

5.00

80.0%

Yes

 Self-induced vomiting

P

4.85 (.46)

5.00

96.2%

Yes

C

4.53 (1.13)

5.00

86.7%

Yes

 Obsessively exercising for the purpose of controlling weight and shape

P

4.15 (.54)

4.00

92.3%

Yes

C

4.60 (1.06)

5.00

93.3%

Yes

 Exercising against medical recommendations

P

4.92 (.27)

5.00

100%

Yes

C

4.60 (1.06)

5.00

93.3%

Yes

 Exercising in secret

P

4.88 (.33)

5.00

100%

Yes

C

4.80 (.56)

5.00

93.3%

Yes

 Refusing to purchase maternity clothing

P

2.96 (.82)

3.00

15.4%

No

C

2.93 (1.22)

2.00

33.3%

No

 Wearing specific clothing to conceal pregnancy

P

2.88 (.71)

3.00

15.4%

No

C

3.67 (1.05)

4.00

68.8%

No

 Misuse of gestational diabetes medication

P

4.96 (.20)

5.00

100%

Yes

C

4.80 (.78)

5.00

93.3%

Yes

 Use of laxatives or enemas to reduce gestational weight gain/induce weight loss

P

4.92 (.27)

5.00

100%

Yes

C

4.80 (.78)

5.00

93.3%

Yes

 Use of appetite suppressants or “diet pills”

P

4.88 (.43)

5.00

96.2%

Yes

C

4.80 (.78)

5.00

93.3%

Yes

 Use of natural supplements (e.g., tea detox)

P

4.81 (.49)

5.00

96.2%

Yes

C

4.67 (.82)

5.00

93.3%

Yes

 Body checking behaviours

P

4.00 (.49)

4.00

88.5%

Yes

C

4.80 (.41)

5.00

100%

Yes

 Self-harm

P

4.85 (.37)

5.00

100%

Yes

C

4.40 (.91)

5.00

86.7%

Yes

 Not consuming enough food during pregnancy to produce milk or sustain breastfeeding, resulting in weight loss and/or binge eating behaviours ^a

P

4.87 (.34)

5.00

100%

Yes

C

4.60 (.63)

5.00

93.3%

Yes

 Spending an excessive amount of time (i.e., multiple hours per week) researching about the most effective ways to reduce pregnancy weight gain and/or ways to lose weight after birth

P

–

–

–

–

C

4.93 (.26)

5.00

100%

Yes

 Searching for or seeking information about disordered eating in pregnancy

P

–

–

–

–

C

4.53 (.92)

5.00

86.7%

Yes

 Using the pregnancy as a ‘valid’ excuse/reason to avoid feared foods and/or not violate dietary rules

P

–

–

–

–

C

4.53 (.52)

5.00

100%

Yes

 Obsessively recording anticipated and achieved weight gain and calculating calorie intake and exercise output to ensure only the absolute minimum weight gain (and feeling distressed if anything interferes with this)

P

–

–

–

–

C

5.00 (.00)

5.00

100%

Yes

 Preferring to ensure the nausea and ignore physical hunger signals due to fear of weight gain or changes to shape

P

–

–

–

–

C

5.00 (.00)

5.00

100%

Yes

 Going to bed hungry at the end of the day and thinking about food, but not allowing oneself to eat to subside this hunger

P

–

–

–

–

C

4.93 (.26)

5.00

100%

Yes

 Excessively reassuring doctors/midwives that low weight during pregnancy OR lack of weight gain is nothing to be concerned about by reporting vague eating habits (e.g., “I eat heaps”)

P

–

–

–

–

C

4.80 (.78)

5.00

93.3%

Yes

 Requesting early discharge from hospital because of the food that might be served and feeling anxious is this early discharge does not or cannot occur

P

–

–

–

–

C

4.73 (.59)

5.00

93.3%

Yes

 Frequent ‘fat talk’ (i.e., if a pregnant woman talks a lot about how ‘fat’ she looks or is)

P

–

–

–

–

C

4.40 (.91)

5.00

86.7%

Yes

 Chewing and spitting out large amounts of food, particularly forbidden foods

P

–

–

–

–

C

4.93 (.26)

5.00

100%

Yes

 Low body weight

P

3.96 (.53)

4.00

96.2%

Yes

C

3.80 (.56)

4.00

73.3%

No

 Losing weight while pregnant

P

4.73 (.60)

5.00

92.3%

Yes

C

3.80 (.68)

4.00

80.0%

Yes

 Inadequate gestational weight gain

P

4.77 (.65)

5.00

96.2%

Yes

C

4.46 (.64)

5.00

93.3%

Yes

 Excessive gestational weight gain

P

3.88 (.65)

4.00

80.8%

Yes

C

3.80 (.68)

4.00

66.7%

No

 Rapid gestational weight gain

P

3.92 (.56)

4.00

80.8%

Yes

C

3.60 (.83)

4.00

66.7%

No

 Dizziness and/or fatigue

P

3.54 (.76)

3.00

46.2%

No

C

2.93 (.80)

3.00

13.3%

No

 Feeling nauseated most of the time

P

2.08 (.85)

2.00

7.7%

No

C

2.67 (1.18)

3.00

20.0%

No

 Severe morning sickness that does not stop after the first trimester (hyperemesis gravidarum)

P

4.31 (.84)

5.00

84.6%

Yes

C

2.00 (1.36)

1.00

20.0%

No

 Dehydration

P

4.58 (.58)

5.00

96.2%

Yes

C

3.27 (.80)

3.00

33.3%

No

 Abdominal bloating

P

3.04 (.60)

3.00

11.5%

No

C

2.93 (.80)

3.00

13.3%

No

 Gastrointestinal discomfort

P

3.00 (.63)

3.00

19.2%

No

C

2.47 (.99)

2.00

13.3%

No

 Unborn baby is small/underdeveloped for gestational age ^a

P

3.96 (.48)

4.00

87.0%

Yes

C

3.47 (.74)

3.00

33.3%

No

 Asymmetrical or slow foetal growth ^a

P

3.96 (.48)

4.00

87.0%

Yes

C

3.53 (.74)

3.00

40.0%

No

 The woman’s blood tests show electrolyte imbalances (e.g., low potassium) ^a

P

4.31 (.84)

5.00

84.6%

Yes

C

4.13 (.74)

4.00

80.0%

Yes

 Overvaluation of body shape and weight

P

4.42 (.50)

4.00

100%

Yes

C

4.93 (.26)

5.00

100%

Yes

 Perceptual disturbance (e.g., perceiving self to be overweight for pregnancy stage, when objectively not)

P

4.42 (.50)

4.00

100%

Yes

C

4.87 (.35)

5.00

100%

Yes

 Poor body image

P

4.12 (.52)

4.00

92.3%

Yes

C

4.47 (.99)

5.00

80.0%

Yes

 Low self-esteem

P

3.77 (.65)

4.00

73.0%

No

C

4.20 (.56)

4.00

93.3%

Yes

 Rumination about gestational weight gain

P

4.04 (.53)

4.00

88.5%

Yes

C

4.87 (.35)

5.00

100%

Yes

 Rumination about health of baby

P

3.08 (.63)

3.00

15.4%

No

C

3.07 (.80)

3.00

20.0%

No

 Fixation on post-partum weight loss

P

4.12 (.52)

4.00

92.3%

Yes

C

4.80 (.56)

5.00

93.3%

Yes

 Self critical thoughts and fear of criticism

P

3.31 (.79)

3.00

42.3%

No

C

4.20 (.56)

4.00

93.3%

Yes

 Comparing personal eating habits to others

P

3.77 (.59)

4.00

76.9%

Yes

C

3.87 (.74)

4.00

80.0%

Yes

 Need for pregnancy to be “perfect”

P

3.88 (.71)

4.00

76.9%

Yes

C

4.20 (.78)

4.00

93.3%

Yes

 Desire for baby to be “small” or “petite”

P

4.73 (.53)

5.00

96.2%

Yes

C

4.20 (1.08)

5.00

80.0%

Yes

 Suicidal thoughts/ideation

P

4.62 (.94)

5.00

88.5%

Yes

C

4.40 (.83)

5.00

80.0%

Yes

 Frequent comparison of weight and shape, with pregnant and non-pregnant women ^a

P

4.74 (.45)

5.00

100%

Yes

C

4.67 (.62)

5.00

93.3%

Yes

 Belief that vomiting will not adversely impact the fetus/baby because “all pregnant women vomit” ^a

P

4.78 (.52)

5.00

96.0%

Yes

C

4.60 (.74)

5.00

86.7%

Yes

 Obsessive thoughts during pregnancy that relate to food (e.g., fear of food contamination, “clean eating” to avoid pesticides) ^a

P

4.74 (.45)

5.00

100%

Yes

C

4.47 (.83)

5.00

93.3%

Yes

 Obsessive thoughts regarding health and normality of pregnancy ^a

P

3.96 (.64)

4.00

87.0%

Yes

C

 Thoughts during pregnancy about using breastfeeding as a purgatory method and/or prolonging breastfeeding for weight loss

P

–

–

–

–

C

4.73 (.80)

5.00

93.3%

Yes

 Agonising and debating the absolute necessity of every food item consumed and/or bargaining with oneself

P

–

–

–

–

C

4.93 (.26)

5.00

100%

Yes

 Urges and thoughts of wanting to vomit to relieve physical or psychological tension

P

–

–

–

–

C

2.93 (1.22)

2.00

33.3%

No

 Thoughts that one does not deserve to eat, and having to justify food consumption ‘for the baby’

P

–

–

–

–

C

5.00 (.00)

5.00

100%

Yes

 Thoughts of wanting to be ‘just bump’ (i.e., weight gain is only acceptable in ‘pregnancy-appropriate’ areas such as the stomach, but not the arms/thighs etc)

P

–

–

–

–

C

4.33 (.82)

4.00, 5.00

93.3%

Yes

 Thoughts of returning to a restrictive diet once the baby is no longer dependent on mother’s body (e.g., to grow in the womb, for breastfeeding, etc)

P

–

–

–

–

C

4.60 (.74)

5.00

86.7%

Yes

 Preoccupation with diets, weight management information, and the lack of weight gained by other pregnant individuals and/or admiration for how rapidly these individuals ‘snap back’ to their pre-pregnancy body weight and shape

P

–

–

–

–

C

4.93 (.26)

5.00

100%

Yes

 Distress regarding changing shape + fear of fatness

P

4.27 (.45)

4.00

100%

Yes

C

4.53 (1.06)

5.00

86.7%

Yes

 Distress or guilt after eating “unhealthy” or “bad” foods

P

4.19 (.49)

4.00

96.2%

Yes

C

4.53 (.83)

5.00

93.3%

Yes

 Mood disturbance

P

3.92 (.80)

4.00

84.6%

Yes

C

3.13 (.99)

3.00

33.3%

No

 Anxiety about certain foods/food groups

P

4.08 (.56)

4.00

84.6%

Yes

C

4.67 (.49)

5.00

100%

Yes

 Feeling “out of control” of one’s body

P

4.27 (.45)

4.00

100%

Yes

C

4.60 (.91)

5.00

86.7%

Yes

 Feeling a “loss of control” over eating

P

4.77 (.59)

5.00

92.3%

Yes

C

4.53 (1.06)

5.00

93.3%

Yes

 Guilt after eating (any food)

P

4.35 (.49)

4.00

100%

Yes

C

4.73 (.46)

5.00

100%

Yes

 Feelings of shame + disgust about body

P

4.92 (.27)

5.00

100%

Yes

C

4.80 (.41)

5.00

100%

Yes

 Sensitivity to comments regarding weight, shape, or appearance

P

4.04 (.60)

4.00

92.3%

Yes

C

4.20 (.94)

5.00

80.0%

Yes

 Emotional detachment from pregnancy

P

4.46 (.86)

5.00

84.6%

Yes

C

4.27 (.82)

4.00

80.0%

Yes

 Social isolation

P

4.31 (.97)

5.00

84.6%

Yes

C

4.47 (.74)

5.00

86.7%

Yes

 Interpersonal mistrust

P

3.73 (.72)

4.00

76.9%

Yes

C

3.73 (.88)

4.00

73.3%

No

 Feeling relieved or thankful for pregnancy serving as a valid explanation to avoid certain foods or eating very little

P

–

–

–

–

C

4.87 (.35)

5.00

100%

Yes

 Distress in relation to increased appetite during pregnancy

P

–

–

–

–

C

4.87 (.35)

5.00

100%

Yes

 Feeling resentful toward the baby for needing constant food and nutrients to grow in the womb, followed by significant guilt and shame for feeling resentful

P

–

–

–

–

C

4.60 (1.12)

5.00

93.3%

Yes