National Eating Disorders Association

Pregnancy and motherhood require a great deal of strength—physically, psychologically, and emotionally. During pregnancy, the growing baby receives all of its nourishment from the mother’s body. When stores of carbohydrates, proteins, fats, vitamins, minerals, and other nutrients are low, a woman’s body will drain them to support the growth and development of the baby. If reserves are not sufficiently restored through healthy eating, the mother can become severely malnourished, and this in turn can lead to depression, exhaustion, and many other serious health complications.

The average woman weight gain can be frightening for many women with eating disorders. Some women with disordered eating are able to more easily cope with weight gain during pregnancy because they see it as a sacrifice for an important cause. But others may plunge into deep depression as they struggle with the tension between the idea of weight gain and their body image issues. Most women with eating disorders fall somewhere between these two extremes.

The Relationship between Specific Eating Disorders and Pregnancy

Women with anorexia nervosa are underweight and may not gain enough weight during pregnancy. They risk having a baby with abnormally low birth weight and related health problems. Women with bulimia nervosa who continue to purge may suffer dehydration, chemical imbalances or even cardiac irregularities. Pregnancy heightens these health risks. Binge eating disorder is correlated with weight gain, which may lead to a greater risk of developing high blood pressure and gestational diabetes.

Risks for the Mother: Poor nutrition, dehydration, cardiac irregularities, gestational diabetes, severe depression during pregnancy, premature birth, labor complications, difficulties nursing, and post-partum depression.

Risks for the Baby: Poor development, premature birth, low birth weight for age, respiratory distress, feeding difficulties, and other perinatal complications. 

Professionals recommend that women with eating disorders do their best to resolve eating disorder-related weight and behavioral problems before they attempt to get pregnant. Eating healthy, well-balanced meals and maintaining a healthy weight for several months before conceiving and throughout pregnancy is important to protecting the health of yourself and your baby.

 It is important to consult with your physician, counselors, and/or registered dietitian before attempting to get pregnant. Women with eating disorders who become pregnant are advised to seek specialized medical and psychological help. Pregnant women with eating disorders should inform their obstetrician about these problems and may require high-risk obstetrical care.

What If I Become Pregnant While Struggling with an Eating Disorder?

Though having an eating disorder may decrease the chances of pregnancy, sometimes women with eating disorders do become pregnant. When this happens, steps should be taken to protect the health of the mother and the baby. Professionals can address the specific needs related to pregnancy and disordered eating only if you are willing to be completely honest with them about your struggles.

If you are pregnant and struggling with disordered eating:

  • Be HONEST with your prenatal health provider regarding past or present struggles with an eating disorder or disordered eating. If they aren’t sensitive to your struggle and concerns, look for a provider who will be more considerate of your experiences.
  • Extra appointments with your prenatal health provider may be necessary to more closely track the growth and development of your baby.
  • Consult a nutritionist with expertise in eating disorders before or immediately after becoming pregnant. Work with the nutritionist throughout the pregnancy to create a plan for healthy eating and weight gain. Continue to see her post-partum. She can help you return to a normal weight through healthy means.
  • Individual counseling during and after pregnancy can help you cope with your concerns and fears regarding food, weight gain, body image, and the new role of mothering.
  • Attend a support group for people with eating disorders.
  • If your doctor approves, attend a prenatal exercise class. It can help you practice healthy limits to exercising.
  • Other classes on pregnancy, childbirth, child development, and parenting skills can also be helpful in preparing to become a mother.
  • Allow your prenatal health provider to weigh you. This information is essential to tracking the health of your baby. If you would prefer not to monitor your weight gain, ask your doctor about standing on the scale backwards and instruct them to not share the number with you.
  • Under certain circumstances, for example if you suffer from severe depression or obsessive- compulsive problems, you may require medications for these conditions even during pregnancy.
  • Tailor your schedule to your pregnancy instead of trying to keep your regular schedule; cut back on commitments and activities if necessary.
  • The skills and support of a multidisciplinary team of health care providers and of family and friends can help you deliver a healthy baby and protect yourself.

Healthy Body Image Tips for Pregnant Women and New Mothers

Be Aware of the Triggers of Pregnancy:

The incessant counting, comparing, and measuring that happens during those nine months and beyond can tap into some of the very vulnerabilities that are linked to eating disorders and food and weight obsessions. Perfectionism, loss of control, feelings of isolation, and memories of childhood often bubble right to the surface. But if you’re getting the support you need, you’ll have a better chance of weathering those storms without resorting to self-destructive habits.

Resist the Urge to Shut Down or Close Off:

Remember that there is nothing shameful about asking for help. It’s the most courageous thing you can do for yourself and your baby. Look at your recovery as an ongoing process that will help you reach your full potential as an individual and as a mother.

Break the Cycle of Body Hatred:

Allow yourself to celebrate the fact that your body is working some serious magic right now. Before you get stymied by stretch marks or focused on flabby skin, take time to reflect on how you will teach your child—in your words and in your actions—that you appreciate your body. We have the power to help future generations grow up placing a higher value on good health than on weight and physical appearance. But before we can pass along those positive attitudes, we must first embrace them for ourselves.

References:

Does This Pregnancy Make Me Look Fat? The Essential Guide to Loving Your Body Before and After Baby by Claire Mysko and Magali Amadei