Calories. Fat grams. Numbers on a scale. As an anorexic I'd spent most of my adolescence and 20s consumed by an unhealthy body image and the desire for control. After therapy and five years at a healthy weight, I thought I was ready for pregnancy. But as my pregnancy progressed, I found myself struggling with old feelings about gaining weight, not being in control of my body, and watching my diet. If you’re a woman with an eating disorder who is pregnant or is planning on getting pregnant here are a few things you should know:
You might think that you’re prepared for the inevitable weight gain of pregnancy. But as the numbers on the scale climbed higher, old feelings about my weight and body crept back into my thinking. I hated seeing that number go higher, and even caught myself restricting calories a few times in order to stop myself from gaining "too much"— common problem for many recovering anorexics.
Anna Barlage, a recovering anorexic and mother of two, also found it difficult watching the numbers on the scale rise. After talking with her care providers she decided to have them take blind weights, i.e. she could not see and they did not tell her the numbers when she stepped on the scale. To this day, she doesn’t know how much weight she gained during her two pregnancies!
If you find yourself obsessing about your weight gain, ask your care providers about options like blind weighing and therapy. “Often women find it helpful to spend more time on the physiological need to gain weight for the developing baby as part of their therapy sessions in order to accept what can feel like a necessary and immense challenge,” says Diane Rubright, PsyD., a psychologist with The Emily Program, a nationwide network of treatment centers for eating disorders.
When I fit back into my pre-pregnancy jeans just two weeks after giving birth, I knew I had a problem.
Changes in Your Body
Swollen feet, leaking breasts, break outs, acid reflux and heartburn—the list of bodily changes during pregnancy is long. At the time I was going through therapy for my eating disorder, the focus was on control issues as being a trigger for an eating disorder. Newer research has shown that the risk of developing an eating disorder is an overlapping Venn diagram of biology, psychology and cultural factors, according to Dr. Jillian Lampert, Chief Strategy Officer at The Emily Program. Control issues overlap between psychology and biology, as research has shown that women who suffer from eating disorders, “like to have things a certain way because it feels betters in their brain,” Lampert explains. The lack of control over my body during pregnancy triggered the desire for me to obsessively micromanage my diet and exercise more. I had to learn how to channel that desire to have things a certain way into other areas—like decorating the nursery and pre-planning meals for the weeks post-delivery.
It’s no secret that women in our society face a lot of pressure to lose the baby weight. From celebrities on magazine covers who "got their body back" to weight loss programs that focus on your postpartum body, it can be completely overwhelming. And that pressure can be magnified for a recovering anorexic. Eating disorder counselors are aware of this issue and “offer a lot of support postpartum as the internal and external messages to lose the baby weight may also be terribly triggering of the eating disorder and put women at risk of unhealthy and rapid weight loss," according to Rubright.
When I fit back into my pre-pregnancy jeans just two weeks after giving birth, I knew I had a problem. I called up my therapist and scheduled an appointment. Be aware that even if you’ve successfully navigated a healthy pregnancy with normal weight gain, an eating disorder could still come up postpartum. Have a therapy plan in place and ask trusted friends to speak up if they notice you losing weight rapidly.
Regardless of where you are in the process of recovering from an eating disorder, you can have a healthy pregnancy and delivery. And pregnancy can even give you a new outlook on your body, one that helps your recovery. As Barlage puts it, “I also appreciate my body so much more now than it has grown two beautiful children, birthed them and nourished them. I honestly think having children ended up strengthening my recovery in the long run.”