Pregnancy and Eating Disorders

This is hard to write about, as ED always is, but there’s a dearth of resources on this, and I hope to add my voice in a way that could be helpful. What follows here is personal experience and personal advice, and not medical advice in any way. At the end of this post, you will find links to resources that I have found supportive and helpful.

Background:

I have struggled with body dysmorphia and disordered eating for most of my post-pubescent life, with a particular crescendo in my late teens and early 20’s. What was unusual about my experience and what made it easy to experience in a vacuum was that I was always pretty “overweight” growing up, so efforts to “control” my weight were celebrated and my methods largely unquestioned. My particular pattern of issues was mostly restriction down to 500 or so calories a day with occasional episodes of binging.

During graduate school, an emotionally abusive relationship drove me into a particular spiral–weighing 260 pounds but restricting to 500 calories a day. My doctor lauded the weight loss that followed–I remember one appointment wherein she literally said to me, “Whatever you’re doing, keep it up!” After graduate school, when my relationship really bottomed out and I could feel a blackhole coming that I might not be able to climb out of, I sought help in the form of outpatient therapy and the use of a holistic nutritionist.

After a long struggle, I’ve been able to mostly manage my darkness with the tools given to me through those services. Bouts pop up, but these are mostly episodes of extreme self-criticism and dysmorphia that don’t usually lead to harsh restricting any more. The truly untenable part is that along the road, my body did come down to a “normal” weight, where it has stayed throughout the subsequent years. I still get comments asking “Wow, what did you do!” to which my honest response is a can of worms few people truly want to open.

My Pregnancy and ED: 

When I first found out I was pregnant, my complete joy had a shadow–the shadow that we all get (“How will I pull this off?” “My cervix is going to be how big?”)–but on top of that, the shadow of extreme anxiety about my changing body. At my first appointment, upon hearing my weight gain plan, I repeated that number over and over again in my head like an image I couldn’t wash out.

Advice I sought initially was really ambiguous–the NEDA hotline told me that you never know how you will respond until it’s actually happening, which I found to be true but also how do you act on that? All I could do was wait and see, and be ready to try to manage whatever reactions I might have.

First trimester was physically horrible–all day nausea, exhaustion, and food aversions. Meanwhile, my body wasn’t gaining weight at that point. In fact, I lost some and was prescribed Diclegis to manage the sickness. But I was so happy for myself because I was thinking, “Wow, I’m not at all freaking out about my body right now!” It took me weeks to connect that I wasn’t freaking out about it because not being able to eat was a lot like my old and horrible friend–restriction.

Second trimester has been a totally different thing. My hunger came back with a vengeance, with cravings for things that ranged from Quarter Pounders w/ cheese and dozens of apples. And with that hunger, as well as a rapidly growing baby, weight has come on. Moments of intensive highs at my adorable bump and feeling the movements of this loved little creature have been paired with lows that bring on old habits, like obsessively taking my measurements and checking the circumference of my wrists and fingers. These activities are especially triggered by comments from others or around the time of OB appointments.

But, I’ve managed. I’m still here, and my habits have stayed positive. These tips and ideas have really helped me do that.

Tips that have been helpful for me: 

  1. Be upfront with your OB about your history or anxieties if they don’t know. During my first appointment, I told the OB that I have a history with ED. She still gave me my weight recommendation, but I have yet to have an appointment since then wherein my weight has been brought up at all. You also do not have to look when they weigh you.
  2. Be upfront with your partner. I have not always personally been super transparent about this with my husband, but pregnancy has created real necessity around it. I am so glad that it has because that honesty has saved me from myself on about a zillion occasions.
  3. Stand up for yourself if people make comments. I’m a teacher, and kids can be unintentionally horrible. I’ve heard, “Wow Miss, you’re getting big!” and “Why are you always eating?” and the only course of action, truly, is to set them straight on things its okay to say and things it isn’t. If you struggle with that, a simple, “That isn’t really your business,” will get your point across.
  4. Try to trust your body and your baby. It knows better than our disorders and our anxieties do about how to make a baby. This is so hard, but it’s really worth the effort. Know that what you crave is your body letting you know what you need. Try to really, really know that. Repeat it and own it.
  5. Focus on that awesome baby. Think about that baby–not just in regards to keeping them healthy, but also the warm fuzzy stuff–how loved they are, how much they love/will love you. Your baby will love you despite your demons. Relish the movements, and invite your partner to do the same.
  6. Do not track food intake. I wanted to do this to keep myself “on target,” but it’s a trigger wormhole for me. Just don’t.
  7. Get maternity clothes as soon as you need them. I’m a broke teacher, so I thrifted a bunch as soon as I could notice a difference in my body. Not only will this keep you comfortable as hell, but it will also save you from the stress of dealing with your pre-preggo wardrobe.
  8. Surround yourself with positive media. As soon as I could feel myself spiraling, I started adding very pregnant-body-positive accounts to my Instagram feed. Users like @birthwithoutfear and @takebackpostpartum, especially the latter, have been everything for me in showing how beautiful and diverse our pregnant bodies are.

Other Helpful Things: 

National Eating Disorder Association

The Body Positive

4 thoughts on “Pregnancy and Eating Disorders

  1. Hi! I have yet to meet you, but I really appreciated this and I think with all people who have had any struggle with their weight. Pregnancy is such a strange time! I also lost some weight in my first trimester, and i told the few people close to me – it’s the only time I felt shameful for losing weight, but also, some pleasure.
    I’m so addicted to my morning weigh in. After having such difficulty with eating that first tri, I’ve been “okay” with anything I eat… but at the same time, just struggle with it. I got pregnancy clothes early, and was so depressed… and then sooo happy with comfortable clothing! I’m just starting to show, but my Belly is soft, so I just feel fat.
    Im just starting that period of starting to need gain weight, and I have a goal, because I stated pregnancy heavier than I would have liked, and I would like to not go over a specific weight. I already have a “plan” to ensure no baby weight after some time of (hopefully successful) breast feeding, while also recently having 3 desserts in one day. It’s a struggle to make overall daily health conscious choices with so many daily changes in our bodies.

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    1. Hi! Thank you! It is really hard, especially with whatever internal voices we have telling us what toxic things we should and shouldn’t do. So much of it for me is trying to tune out the noise, and trying to appreciate the changes. If the belly stays soft, so be it, if it hardens up, so be it. It all just is what it is, you know? Amen on the idea of hopefully successful breastfeeding…somehow that scares me more than birthing an actual child. 🙂

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  2. When I initially read your post, it was hearing something in myself that I hadn’t shared with anyone. So, while your post was such thoughtful, mindful sharing, mine was verbal spewage of the inner voice. After responding, I felt relieved to share, but also wish my written share would have been more thoughtful, like yours. For me, owning up to how I’m feeling leads to less guilt and self doubt, and negative behaviors associated. I’m just starting to tell people over the past week, so after this, I’ve been more honest when people ask how I’m feeling. It’s allowed more honest discussions than just talking about the now resolved nausea and still present fatigue. I don’t know that I would have done that if I had not read this, so thank you!

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    1. I’m all about verbage spewage of one’s internal voice 😉 With issues like these, I think all we honestly really have sometimes is our verbal spewage. And there’s also such a negative taboo around saying anything remotely malcontent while pregnant, but no, I don’t feel great and glowy all the time, yes I am worried about my body, etc. etc. But I’m so glad to have opened up a dialogue! We can always be long distance preggo buddies.

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