Eating Disorders and Pregnancy: Q&A

Pregnancy is one of the most unique times in a women’s life, with her body goes through an intense transformation in a short period of time. As she watches her belly expand, her hips widen and her skin undergo its own changes, it can be hard to recognize that person staring back in the mirror. The stress of not feeling in control of one’s own body can be all too familiar to a woman who has struggled with disordered eating. There is a common misconception that pregnancy is a time of joy and body acceptance, but for many women, it can be a time of uncertainty and fear as our bodies undertake the job of creating life. These feelings of being out of control can cause relapse of previous eating disorders, as well as bring on a new eating disorder in many women. 

With the mortality rate for eating disorders surpassing that of all other mental illness [1], it is urgent for this issue to be brought to light and for those who are suffering to be able to speak openly about it without shame.  During pregnancy, there is a logical instinct to care for yourself and your unborn baby, however, for some women there is an “eating disorder voice” that can be a constant source of anxiety and guilt. Once we recognize that we may be reaching for unhealthy coping mechanisms during our pregnancy, then we can fearlessly move forward to that next step of getting help.

What are the risks of eating disorders during pregnancy?

The risks of having an existing eating disorder or developing one during pregnancy has negative effects on both you and your unborn baby. Anorexia nervosa, which includes extreme weight loss and restriction, could lead to miscarriage, stillbirth, low birth weight or hindered development. Bulimia, which involves binge eating large amounts of food and then purging through vomiting or exercise, can have the same effects on the body and could also lead to other health issues- such as dehydration and trouble breastfeeding. Binge eating disorder- consuming large quantities of food at one time to the point of discomfort, followed by feeling of shame and guilt in one’s own body- is also detrimental to you and your unborn baby. Binge eating disorder increases your risk of gestational diabetes, preeclampsia and needing a C-section [4]. Weight gain during your pregnancy should be discussed with your doctor, and by advocating for your own mental and physical health, you will better ensure that you are getting the support you need.

What are the signs and symptoms of an eating disorder
during pregnancy?

Common signs and symptoms may
include:

• Little to no weight gain or weight loss throughout the pregnancy

• Restriction of major food groups

• Feeling fearful of becoming overweight

• Engaging in extreme forms of exercise to burn calories

• Inducing vomiting to get rid of food eaten

• Chronic fatigue

• Dizziness, headaches, blacking-out

• Skipping or avoiding meals

• Difficulty concentrating

• Social avoidance of family or friends

• Increased depression or anxiety [5]

Will I pass on my eating disorder to my unborn child?

Research shows that there is a small genetic component to eating disorders, similar to the genetic contribution of other mental health disorders (bipolar disorder, schizophrenia, etc.). Although this may not be a predictive factor, it has been shown to be a contributing factor [3]. Researchers feel that there are environmental factors in the role of the development of an eating disorder, where up to 50-70% is genetic, while 30-50% is environmental. That environmental factor includes family upbringing, social development, societal pressure, perfectionist
traits and learned coping skills. Children model the behavior they see in their caregivers, and that includes attitudes towards food and body image. If you are constantly critiquing your body in front of your child, or they rarely see you eating meals, then they could begin to develop similar traits- viewing it as the standard to adhere to. If we can work towards changing our habit of
negative self-talk to a more compassionate one that involves active acknowledgement of how our behavior is influencing our children, then we can work towards setting that healthy foundation of our child’s own healthy self-image.  

How does pregnancy contribute to body image?

Anyone can develop an eating disorder during pregnancy, and research has mixed outcomes when it comes to the likelihood
of developing one. For some women, the eating disorder remains the same during her pregnancy, and for others, pregnancy may cause a past eating disorder to resurface [2]. However, pregnancy can also be a motivation for many women to recover from
their eating disorder, as they come to view their body in a brand-new light. With pregnancy comes an extreme transformation of your body over a short period of time, and that could cause distress in some women, neutrality, or adoration and awe- all of which are completely normal. A way to help combat feelings of
anxiety and distress for your changing body could be to practice a perspective shift, a way of thinking that will soon become a healthy habit. Instead of viewing your growing body in a negative light, see it as a vessel of life that is capable of amazing things. Practice shifting your inner dialog to one of a true warrior woman in the mirror, one that your baby is depending on for their own strength and courage before they enter the world.

References

[1] https://www.mirasol.net/learning-center/eating-disorder-statistics.php#:~:text=How%20Dangerous%20are%20Eating%20Disorders%3F%201%20Eating%20disorders,rate%20associated%20with%20anorexia%20nervosa%20is%2012%20times

[2] Ward, V. B. (2008). Eating disorders in pregnancy. BJ: British
Medical Journal, 336(7635), 93–96. http://doi.org/10.1136/bmj.39393.689595.B

[3] https://www.geneticliteracyproject.org/2015/02/23/you-are-what-you-dont-eat-genetics-of-anorexia-and-bulimia-nervosa/

[4] https://americanpregnancy.org/pregnancy-health/pregnancy-and-eating-disorders/

[5] Ekern, Jacqueline. 2012. Eating Disorder Hope. Eating
Disorders and Pregnancy. www.eatingdisorderhope.com