Pregnancy and Eating Disorders – How to Handle It?

By: Heather Maio, Psy.D., Assistant Vice President of Clinical Services for The Renfrew Centers and Clinical Director of The Renfrew Center of Florida.

Biography:
Dr. Heather P. Maio is a Licensed Clinical Psychologist who serves as Assistant Vice President of Clinical Services for The Renfrew Centers and Clinical Director of The Renfrew Center of Florida. Dr. Maio has extensive experience working with adolescents, adults, couples and families. Her special interests include the treatment of eating disorders, substance abuse, relationship issues, women’s issues and Motivational Interviewing. Dr. Maio maintains a private practice in Boca Raton, Florida, and presents trainings and webcasts frequently on eating disorders and related topics including the need for eating disorder awareness and advocacy for access to treatment.

Pregnancy for many women is a joyous time when the body provides for the unborn child and excitement builds for the pleasures, challenges and triumphs that come with bringing a new life into the world. Yet for others the thought and experience of being pregnant is terrifying. The “unknown” of their weight, pressures to keep fit and loss of control creates tremendous anxiety, stress and panic.

Struggling With A Negative Body Image

When pregnant the stomach grows, a fact we all know, but for someone struggling with negative body image or disordered eating this fact is very scary. Not only is the stomach growing, but there is weight gain and changes to the body that a pregnant woman can’t control.

Furthermore, she may be feeling pressure from partners, family members, peers and society to gain minimal weight while maintaining a “healthy” pregnancy and keep her personal training routine throughout the nine months. These types of pressures can lead women to have increased feelings of inadequacy, negative body image and low self-esteem putting them at greater risk for developing eating disorder behaviors during and/or after pregnancy.

Feeling A Loss of Control Over the Body

Pregnant women also report that the loss of control that one often experiences throughout pregnancy can provoke anxiety and allow the opportunity for eating disordered behaviors or eating disorders to emerge. The nausea and vomiting that often occurs during the first trimester can allow for long periods of restrictive food intake. For those who have struggled with anorexia or bulimia in the past, this may trigger the reemergence of an underlying eating disorder and ultimately lead to a relapse.

Furthermore, women may often feign “morning sickness” giving themselves an excuse to restrict or vomit, thus masking an undiagnosed eating disorder. Conversely, women will report “I am eating for two; the baby is hungry,” as a pro-social explanation for over eating or binge eating.

The stressors of pregnancy are many, but there are things that can be done by both the mother-to-be and support persons to make this a more joyous time. Below are a few tips.

Tips for A Pregnant Woman and Her Loved Ones

Tips for struggling with body image and/or eating disorders during pregnancy:

• Include your significant other in the pregnancy progress.
• Talk about how you are feeling. Talk to your doctor about any depression, anxiety, fears you may be experiencing.
• Be open and honest with your significant other and your OB/GYN. If you have an eating disorder it is important that your OB/GYN has specialized experience and understanding of eating disorders.

• Be specific with your doctor(s) about what you are and are not eating, and exactly how much you are exercising. (Do not wait for them to ask you.)
• Make sure your doctor knows about your eating disorder history, as well as any slips or relapses you experience.
• Start or continue in therapy, allow for open communication with all treatment providers.
• Educate yourself on what nutrition your baby needs.

Tips for loving and accepting your pregnant body:

• Connect with the baby growing inside your body. Talk to your baby; The more connected you are with the baby growing inside of you, the less distress you may feel about the changes associated with it.
• Think of what your body is doing for your unborn child, how the changes are supporting the life growing inside you.
• Give yourself “permission” to gain weight for your baby.
• Find re-assurance in knowing that your body changes are temporary.
• Meet with your nutritionist and therapist to discuss healthy ways to lose the pregnancy weight after the baby is born.
• Enroll in pre-natal yoga or physical fitness activities that are specific to the needs of pregnant women.
• Remember to pamper yourself when you can… do things that make you feel attractive and aid in distressing and relaxation. These can be as simple as a warm shower or bubble bath, or more luxurious as a manicure/pedicure and pre-natal massage.

Tips on how a loved one can help:

• It is important that you are supportive.
• If the mother-to-be would like you to: attend doctors’ appointments, classes and supports groups, it is important you go with her.
• Listen to her fears and talk about yours. Plan for how you will support each other, and be reassuring.
• Tell her she is beautiful.
• Remind her that all of her body changes are in support of her growing and developing baby.
• Focus on feelings not weight and food.
• Express your concerns, be open and honest if you see her engaging in behaviors that are concerning.

Being pregnant is no doubt an exciting but stressful time. Steps taken now to ensure a healthy pregnancy can last a lifetime for both the mother and child. If you or someone you love is struggling with negative body image or disordered eating speak with your primary care physician or a treatment facility, such as The Renfrew Center, which specializes in this type of care.