Attitudes toward gestational weight gain and exercise avoidance tendencies: a latent profile analysis and mediation test of internalized weight bias in pregnant women

Objective This study aimed to examine the association between attitudes toward gestational weight gain and exercise avoidance tendencies among pregnant women from both variable-centered and person-centered perspectives. Specifically, it tested whether internalized weight bias in pregnancy statistically mediated this association and identified latent heterogeneous profiles of gestational weight-gain attitudes and their psychological and behavioral correlates. Methods A cross-sectional survey design was adopted. A total of 433 pregnant women were recruited from March to May 2026. Measures included the Pregnancy and Weight Gain Attitude Scale, the Weight Bias Internalization Tool for Use in Pregnancy, the Tendency to Avoid Physical Activity and Sport Scale, and essential demographic information. Results Attitudes toward gestational weight gain, internalized weight bias in pregnancy, and exercise avoidance tendencies were significantly and positively correlated with one another. The cross-sectional mediation model showed that attitudes toward gestational weight gain not only directly and positively was associated with exercise avoidance tendencies but also exerted a significant indirect association through internalized weight bias in pregnancy. Latent profile analysis supported the two-profile solution as the optimal model, classifying attitudes toward gestational weight gain into a “low concern profile” and a “high concern profile.” Pregnant women in the high concern profile reported significantly higher levels of internalized weight bias and exercise avoidance tendencies than those in the low concern profile. Conclusion Negative attitudes toward gestational weight gain are closely associated with exercise avoidance tendencies among pregnant women, and this association was statistically mediated by internalized weight bias in pregnancy. Because these findings are cross-sectional, they highlight the need for future research to examine whether non-stigmatizing perinatal care that attends to attitudes toward gestational weight gain and offers individualized psychological support may help reduce exercise avoidance and promote maternal and infant wellbeing.