There are plenty of challenges that come with pregnancy, from discomfort to anxiety to money worries. Add an eating disorder to the mix and the challenges grow exponentially.
There are surprisingly less definitive studies and research on eating disorders than you might think: these problems are slippery, often lifelong, and deeply personal. Many women are unwilling to share their experiences or seek help, and the warning signs of disorder often look “normal” in today’s Insta society.
“Pregnant women may experience magnified feelings of guilt and shame over the potential for harm to their baby,” the site Very Well Mind states. “They also often fear judgment from others. As a result, they may be reluctant to disclose their problem, and in many cases may not believe or admit to themselves they even have a problem.”
The truth is, about seven to 10% of pregnant women have an eating disorder.
Facing Higher Risks
There are always risks with pregnancy, but eating disorders up the ante. Anorexics have the highest rate of unwanted, unplanned pregnancies, probably because low body fat causes dysmenorrhea (stopped or infrequent periods), so anorexics think pregnancy is an impossibility.
Women with an active eating disorder during pregnancy (anorexia, bulimia, etc.), are at greater risk for delivering preterm or low birth weight babies, needing a c-section, or developing postpartum depression.
The site Eating Disorder Hope gives advice towards helping counter weight anxiety, like having some emotional support through an understanding OB/GYN. In addition, “…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.”
Dietician and Maternal Health Specialist Crystal Karges recommends a team effort for pregnant women with pre-existing eating disorders. “This may involve having both a therapist and registered dietitian who specialize in eating disorders, who are working alongside the mother’s provider, whether an OB/GYN or midwife,” Karges tells Parentology.
Eating Disorders Don’t Stop During Pregnancy, They Morph
A study in the BMC Pregnancy and Childbirth journal called “The experience of women with an eating disorder in the perinatal period: a meta-ethnographic study,” found that eating disorders simply take on new forms during pregnancy.
“The main theme that emerged for women with an eating disorder during pregnancy was navigating a ‘new’ eating disorder. The key theme that emerged for women with an eating disorder post-pregnancy was a return to the ‘old’ eating disorder,” the study cited.
It became a constant and daily struggle for many of the 94 subjects, as they encountered an ever-changing body and reactions to it from outsiders.
One woman wrote: “…I struggled you know, dealing with the weight gain, kind of between not liking it and being uncomfortable with it but also knowing that it needed to happen to have healthy babies, so it was kind of a constant struggle.”
Overall, the women tended to make decisions based on the health of the baby, trying daily to put ongoing weight anxiety and unhealthy eating urges aside. For some, pregnancy offered some relief from the pressure of unhealthy body image, with pregnancy being an “excuse” to eat normally and put on weight.
The Disorder Often Returns Postpartum
While the majority of women with eating disorders might manage to navigate the “new” disordered scenario presented during pregnancy, postpartum marks an unfortunate return to original problems.
“The main theme that emerged for women with an eating disorder following the birth was a return to the ‘old’ eating disorder,” the study observed. “During this time women experienced an overwhelming desire to lose weight and a pull to return to the old and comfortable eating disorder behaviors.”
Given the pressure all women face postpartum to shed that “baby weight,” this conclusion is probably predictable. However, women with an existing eating disorder focus upon it during the postpartum period differently, often foregoing breastfeeding and engaging in obsessive exercise patterns. This might be the time when women need help the most.
“…there is need not only to conceptualize the experiences of pregnancy for those with an eating disorder in the antenatal period, but also during the immediate postpartum period and up to the infant age of two years,” the study’s authors concluded.
Karges concurs, adding that “Mothers with eating disorders have an increased risk of experiencing a perinatal mood and anxiety disorders (PMADs) during pregnancy and postpartum. This includes conditions like postpartum depression/anxiety, or postpartum OCD.”
Additionally, Karges says, “So while a mom with an eating disorder might not necessarily relapse into maladaptive eating behaviors, she may struggle with mental illness in the form of a PMAD. For this reason, it’s crucial to stay connected to support to help monitor the mental and physical health and well-being of a new mom.”