Eating Disorder Relapse During Pregnancy

Pregnancy takes a lot of physical, mental, and emotional energy. This is a vulnerable time not only for babies, but for pregnant people as well. For people with eating disorders, the physical and mental stressors that come from pregnancy can trigger a relapse.

Risks of Relapse During Pregnancy

Eating disorder behaviors can be harmful for the pregnant person and their baby [1]. The risks to pregnant people are:

• Dehydration
• Malnourishment
• Gestational diabetes
• Heart problems
• Severe depression during pregnancy
• Complications during labor
• Issues with breastfeeding
• Postpartum depression [1].

There are also risks for the baby as well. These include:

• Issues with development
• Increased risk of miscarriage
• Premature birth
• Low birth weight
• Respiratory problems

There is a wide range of eating disorder behaviors. Different behaviors come with different risks. For example, pregnant people struggling with anorexia may not gain enough weight during pregnancy and then their baby may also be underweight [1]. In comparison, binging behaviors may place someone at increased risk for high blood pressure or gestational diabetes [1].

Getting Eating Disorder Treatment While Pregnant

Unfortunately, there is a lot of stigma with eating disorders. This is especially true for pregnant people. For this reason, many people do not want to share with their doctors or other healthcare providers that they are struggling with disordered eating [2]. However, it’s important to be honest so that you can get the help you need. This is important for your health and your baby’s.

Talking with your doctor can help support your baby’s growth throughout pregnancy. Your doctor may also be able to provide extra support through extra appointments, nutritional support, or referrals to eating disorder specialists. It can be scary to have this conversation. If your doctor is not supportive, then consider changing to a provider who is understanding and can support you during this very important time.

However, it can also be helpful for doctors who work with pregnant women to screen for eating disorder behaviors. This can help doctors provide support and to be aware of any warning signs for disordered eating [2].

It can also be helpful to see an eating-disorder informed dietitian and therapist. A nutritionist can help you develop a meal plan that will support healthy weight gain and your nutritional needs during pregnancy.

A mental health therapist can also help you with the psychological and emotional aspect of the eating disorder. Eating disorders are not just medical conditions, there is a large emotional piece. A therapist can help you figure out different ways to cope and how to deal with the unique emotions that come up during pregnancy. 

Relapse Prevention During Pregnancy

If you have struggled with an eating disorder in the past, it’s important to be aware of the risk of relapse during pregnancy. There is always a risk, but there are unique stressors with pregnancy that may trigger a relapse or make recovery more difficult to maintain.

A relapse prevention plan is basically a plan for how to deal with triggers or urges to engage in eating disorder behaviors. Some common triggers during pregnancy include:

• Body changes- It is common knowledge that bodies change a lot during pregnancy. Weight gain can bring up a lot of fear, anxiety, insecurity, or sadness.
• Increased focus on weight- During pregnancy, there is an increased focus on weight. This is because weight gain is important for the baby’s development. Doctors may weigh you more often or do other things to measure growth. This can shift someone’s focus to their body shape and size.
• Reminders of childhood- Many pregnant people have reminders of their own childhoods during pregnancy. Depending on how your childhood was, this can cause a lot of emotions to resurface. Someone may use disordered behaviors to cope with these feelings or memories.
• Perfectionism- Perfectionism is linked with eating disorders. Pregnancy can enhance someone’s perfectionistic tendencies. Whether they are wanting their body to look perfect or they want to do pregnancy perfectly, this pressure can be triggering [1].

There’s likely a lot of other things that may trigger a relapse during pregnancy. In addition to the unique stressors that pregnancy brings, each person has their own unique stressors. Being aware of what those triggers are and planning ahead for how to deal with them can be helpful.

Pregnancy is a uniquely emotional and vulnerable time. Don’t let an eating disorder rob you of the special moments that this time can bring. Reach out for help. You deserve a healthy pregnancy.

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Resources:

[1] National Eating Disorders Association. (2018). Pregnancy and eating disorders. https://www.nationaleatingdisorders.org/pregnancy-and-eating-disorders

[2] Franko, D.L. & Spurrell, E.B. (2000). Detection and management of eating disorders during pregnancy. Obstetrics and gynecology, 95(6), 942-946.

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About the Author:

Samantha Bothwell, LMFT, is a licensed Marriage and Family Therapist, writer, explorer, and lipstick aficionado. She became a therapist after doing her own healing work so she could become whole after spending many years living with her mind and body disconnected. She has focused her clinical work to support the healing process of survivors of sexual violence and eating disorders. She is passionate about guiding people in their return to their truest Self so they can live their most authentic, peaceful life.

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The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a 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 May 11, 2021 on EatingDisorderHope.com
Reviewed & Approved on May 11, 2021, by Jacquelyn Ekern MS, LPC