Dealing with Pregnancy and Eating Disorders, What to Expect

There are few times during women’s lives that are as miraculous, momentous, vulnerable, and inexplicable as pregnancy. To inherit the responsibility of carrying another precious being within your own body is truly life-altering.

For approximately nine months, your body becomes a vessel in which your baby grows and develops. The pregnancy journey brings about raw emotions that may have never been perceived or understood before:

• Fears
• Apprehensions
• Surges of joy
• Overwhelming love for your child to come

Couple this alongside the physical changes that occur throughout pregnancy and it can make for a roller coaster of an adventure.

Eating Disorders and Pregnancy

Pregnancy, with all its complexities and delicacies, can be further complicated by an eating disorder. With an estimated 10 million females struggling with these mental illnesses, it is not uncommon for a woman to develop an eating disorder, such as anorexia, bulimia, or binge eating disorder, during her childbearing years.

Many aspects of pregnancy can be frightening in itself to any woman, such as the several biological changes that occur and the necessary weight gain. For a woman who is struggling with an eating disorder or body dysmorphia, these fears can be exacerbated to an entirely new level as the battle against her eating disorder is fought not only for her own life, but for the life of her unborn child as well.

Research has shown variable outcomes for women with past or current eating disorders who become pregnant [1]. For some women, the eating disorder may continue unchanged during the pregnancy [2]. For some women with a history of an eating disorder, pregnancy may trigger a relapse, either during pregnancy or in the first six months postpartum [3]. Yet for many women with a past or current eating disorder, pregnancy may be a time of motivation for recovery.

Putting the Child in Danger

These challenges for a pregnant woman suffering with an eating disorder can evolve throughout the pregnancy, as each trimester brings about varying encounters.

From conception to delivery, each day of the development process of your baby is critical and vital; with the choices you make directly affecting your unborn child. Let us examine each of the three trimesters of pregnancy to determine what challenges may be particularly difficult for a woman with an eating disorder, as well as ways to overcome these challenges to achieve the best possible outcomes for you and your baby.

The 1st Trimester – From Conception to the 12th Week of Pregnancy

The first trimester is likely the time that you may discover you are pregnant. The news of expectancy can incur feelings of excitement and trepidation of the unknown. You will notice that your body is undergoing many changes to accommodate the new baby. These changes can generate symptoms that can be unpleasant in the first weeks of pregnancy, such as:

• Extreme fatigue
• Mood swings
• Food cravings or aversions
• Morning sickness
• Weight gain/loss

Experiencing one or more of these symptoms may or may not trigger eating disorder behaviors. If you are struggling with an eating disorder and discover you are pregnant, it is crucial that you seek prenatal care as soon as possible. This is also a good time to reconnect with your eating disorder treatment team for extra support during your pregnancy.

Depending on the severity of the eating disorder, this might involve day treatment, intensive outpatient care, a support group, or reestablishing care with a therapist.

Discuss any symptoms you may be experiencing with your doctor or midwife and communicate openly with them if you are actively struggling with your eating disorder.

If consuming adequate nutrition is challenging for you because of food aversions, nausea, or vomiting, it may be helpful to meet with a nutritionist who can ensure that you are eating sufficiently for you and your baby.

The 2nd Trimester – Weeks 13-28

In the second trimester, you may find that symptoms like nausea and fatigue have subsided, though other changes are evolving as your baby develops. In the second trimester, it will be more noticeable that your abdomen is expanding to adjust to your growing baby.
It is not uncommon to develop stretch marks during this time or undergo changes to skin color and texture. While this is normal during pregnancy, this can be remarkably painstaking for a woman suffering with an eating disorder.

Potential Weight Gain

The weight gain that naturally occurs can be upsetting, especially if low body image and self-esteem was a struggle prior to pregnancy. You may also experience your baby moving for the first time during the second trimester. This is a beautiful reminder of the precious baby that is growing within you. As your baby develops, keep in mind that healthy weight gain is needed. The American College of Obstetricians and Gynecologists (ACOG) recommend that women gain 25-35 pounds during pregnancy.

If weight gain is overwhelming you during your pregnancy, ensure that you have professional and moral support and trusted people with whom you can discuss your concerns. You might also consider having blind weights at your doctor’s appointments or ask your healthcare provider not to discuss your weight directly with you. Ideally, your treatment team can collaborate with your physician/midwife in order to help convey this information, but remember that you can be an advocate for yourself as well!

The 3rd and Final Trimester – Weeks 29 to Birth

In the final trimester of your pregnancy, weeks 29-40, you may experience new body changes as you prepare to birth your baby. As you near your due date and your baby grows closer to term, you may find yourself feeling physically uncomfortable. Your baby may be putting pressure on your organs, which can have an impact on:

• Digestion
• Feelings of hunger and fullness
• Your ability to eat sufficiently

If you have an eating disorder, you may find that it is easy to use these discomforts as an excuse for restricting or engaging in other disordered eating behaviors.

To prevent preterm labor and delivery, continue to meet regularly with your doctor, midwife and nutritionist. Another challenging aspect of this trimester is the unwarranted comments you may be receiving from friends, family, and strangers, such as “You’re getting really big!”, or “You look like you’ve put on a lot of weight!” etc. These comments can be even more hurtful when you’re suffering with low body image and can easily trigger a relapse into disordered eating.

Discuss these comments with your close knit circle of support, or consider meeting with a counselor or therapist to deal with them effectively. Allowing these emotions to fester within yourself can be harmful to you and your baby, so be sure to utilize healthy coping mechanisms instead of resorting to your eating disorder.

Higher Risk of Cesarean Section

Research has shown that women with an active eating disorder during pregnancy are at greater risk for:

• Having a Cesarean section
• Delivering preterm babies
• Delivering low birth weight babies
• Developing postpartum depression

However, there is promising news. Research has demonstrated that women who are able to get appropriate prenatal care and keep their eating disorder under control will have a normal, healthy pregnancy and baby. The battles and demons you may face in your eating disorder may become magnified during pregnancy, but you will be embodied with a renewed strength to fight on behalf of your growing baby.

How Pregnancy Can Help

For many women, pregnancy is a time that encourages self-care and motivates the prioritization of treatment for an eating disorder. Taking the necessary steps to support your eating disorder recovery can help give you the best possible experience, while supporting your overall health and wellness.

Your body is a beautiful, magnificent vessel for your growing baby, capable of loving your child in ways you never thought possible. As you journey through this great adventure, let this be your strength in the face of any fear your eating disorder dare send your way.

 

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About the Author: Crystal Karges, MS, RDN, IBCLC is a Contributing Writer for Eating Disorder Hope.

Crystal is a Masters-level Registered Dietitian Nutritionist (RDN) with a specialty focus in eating disorders, maternal/child health and wellness, and intuitive eating. Combining clinical experience with a love of social media and writing.  

As a Certified Intuitive Eating Counselor, Crystal has dedicated her career to helping others establish a healthy relationship with food and body through her work with EDH and nutrition private practice.

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References:

[1]:  Ward, V. B. (2008). Eating disorders in pregnancy. BMJ : British Medical Journal, 336(7635), 93–96. http://doi.org/10.1136/bmj.39393.689595.BE
[2]: Larrson G, Andersson-Ellstron A. Experiences of pregnancy-related body shape changes and of breast-feeding in women with a history of eating disorders. Eur Eat Disord Rev 2003;11:116-24.
[3]: Pregnancy and neonatal outcomes in women with eating disorders. Koubaa S, Hällström T, Lindholm C, Hirschberg AL Obstet Gynecol. 2005 Feb; 105(2):255-60.

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The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published: June 8, 2017.
Edited And Updated By: Crystal Karges, MS, RDN, IBCLC.
Reviewed By: Jacquelyn Ekern, MS, LPC on June 8, 2017.
Published on EatingDisorderHope.com