only 30–40% of US women gain in accordance with advised
clinical recommendations (5,6). Between 35 and 60% of pregnant
women reported receiving no advice from their providers
about appropriate pregnancy weight gain (7,8).
In the face of persistent nonadherence to expert consensus
together with the wide variability in the amount of weight
gained during pregnancy, more researchers have acknowledged
that the determinants of the adequacy of GWG are multi-
factorial in nature (7–9). More comprehensive analyses are
needed that include biological characteristics and modifiable
psychosocial and contextual indicators as predictors of weight
gain during pregnancy. Whereas, the bulk of research in this
area has emphasized the former (e.g., pregravid BMI, parity,
height, race, age, age at menarche), the value of identifying
pertinent psychological, sociocultural, and behavioral risk factors
for inadequate and excessive GWG has gained momentum
in the scientific literature in recent years (10,11).
The biopsychosocial model (12) provides a flexible framework
from which to explore the complex, multidimensional
determinants and causal mechanisms that support inadequate