Eating Disorders and Pregnancy: What to Expect ?
Written by ‘Ai Pono Hawaii Staff Writer
Navigating pregnancy while in recovery no matter where you are in the process can feel overwhelming. Fortunately, with the right care and support a healthy pregnancy is possible.
In this article, we’ll discuss:
Pregnancy during recovery
Complications of eating disorder symptoms during pregnancy
How to manage recovery during pregnancy
Seeking a higher level of care while pregnant
What to expect in treatment while pregnant
Postpartum concerns
Pregnancy during Eating Disorder Recovery
Becoming pregnant while actively struggling with an eating disorder or while seeking treatment may bring along many concerns. One study estimated eating disorders affect 5-8% of women during pregnancy, so if you or a loved one are in this position, you are not alone.
There are many different ways pregnancy may impact those struggling with an active eating disorder or history of disordered eating. For some, eating disorder symptoms may continue without changes during pregnancy. For some with a history of disordered eating, pregnancy can cause a relapse of symptoms during or postpartum. For some, pregnancy can be a catalyst for a newfound inspiration for change and dedication in recovery.
Pregnancy impacts everyone differently, but with awareness to the risks and having a plan to reduce symptoms and prioritize recovery.
Potential Complications Pregnancy due to Eating Disorders
It is important to understand how eating disorder behaviors may impact the mother and baby’s health. Eating disorders can cause medical complications during pregnancy, especially if disordered behaviors are not addressed. While different eating disorders such as Anorexia, Bulimia and Binge Eating Disorder may result in different complications, these risks can occur alongside any symptoms.
Some health risks include:
Abnormally low birth weight
Dehydration
Chemical imbalances
Cardiac irregularities
High blood pressure
Gestational diabetes
Delivering preterm babies
Developing postpartum depression
Difficulties nursing
However, with proper care and support during pregnancy, it is possible to experience a healthy pregnancy and eating disorder recovery.
How to Manage Recovery During Pregnancy
There are many ways to support recovery during pregnancy. Here are a few steps that may help you manage symptoms during this time in your life:
1. Be honest with healthcare providers
To ensure you are getting the best care and support possible, it is important to be honest with the doctors and providers you are seeing about your history and/or your current struggle with eating disorder behaviors. You may also want to have your providers to be able to communicate with other members of your healthcare team you are seeing to have all of your support connected.
2. Request providers handle weight concerns gently
Throughout your pregnancy your OB/GYN and any other providers you are seeing will likely require monitoring your weight. To help you stay on track with recovery, remember you have the right to request to not see your weight, to hear your weight, or for it to be marked on your electronic file if you have access to it. If concerns around your weight are brought up, you can ask for it to be discussed delicately or for them to inform a member of your care team who may be better suited to discuss these concerns such as a dietitian with eating disorder experience.
3. Shut down body comments
Our society has normalized commenting on pregnant women's body size. Commenting on how big or small someone is, or how they “carry weight” during or after pregnancy has become an unfortunate norm. This can be extremely upsetting or distressing to someone who is struggling with their body image and concerns of weight gain and body changes. You have the right to tell others to not comment on your weight or body whether it is family, friends or strangers. You can work with your therapist to come up with some responses to rely on in these difficult moments and discuss what comes up for you should you hear a comment about your body that is triggering.
4. Work with an Eating Disorder Dietitian
Working with a dietitian during your pregnancy is an important piece of your treatment team to help you monitor and manage symptoms. Your dietitian can help with creating or continuing to follow a meal plan and offer a safe space to discuss food anxiety, struggles with weight gain, and relapse. Your dietitian can also be a great resource to ask questions and learn more about the importance of nutrition and weight gain during pregnancy.
5. Seek Support from an Eating Disorder Therapist
During and after pregnancy having support from a therapist with a specialization in eating disorders is a vital resource for a healthy pregnancy both emotionally and physically. With your therapist, you can work through thoughts and concerns you have regarding weight gain, body image, and becoming a parent. Your therapist can provide recommendations on what type of support may be necessary or recommended for both you and your baby’s health and wellbeing. This may look like suggesting more frequent sessions, seeking out a higher level of care, or joining a support group.
6. Support Groups
A support group can be a great way to lessen feelings of isolation and feeling alone in your struggle. Being able to connect with others in recovery and sharing your experiences and concerns can be an empowering experience to continue fighting your eating disorder.
Seeking A Higher Level Of Care While Pregnant
In some cases, it may be necessary to seek out a higher level of care during pregnancy to aid in reduction and management of eating disorder symptoms. While making a decision to seek out Intensive Outpatient Treatment or Residential Treatment may seem overwhelming, this support can allow you to prepare for motherhood and put yourself in the best position possible with recovery.
Some expecting mothers may feel a great deal of shame for struggling with symptoms and needing to seek out a higher level of care. It is important to remember that eating disorders are not a choice and needing more support is nothing to feel ashamed about.
A supportive treatment team, like you’d find at ‘Ai Pono, understands the difficult decision you have made to prioritize recovery during this important stage of your life and are ready to meet you wherever you are to best support you on the road to recovery as you enter motherhood.
What to Expect in Treatment While Pregnant
Treatment is personalized to address your specific history, current struggles and goals in recovery. If you are seeking a higher level of care while pregnant here are some areas you may focus on with your treatment team in an Intensive Treatment Program or Residential Program:
Reduction of eating disorder symptoms
Identifying food rules and rituals and exposure to break these
Addressing co-occuring mental health conditions such as anxiety, depression, PTSD, bipolar disorder
Educating your support system and strengthening their ability to support your recovery during and after treatment
Discussing anxiety or fear around motherhood
Learning ways to prioritize self-care
Coping skills to work through eating disorder urges
Participating in group therapy
A relapse prevention plan for post-treatment
Postpartum Care
While managing eating disorder symptoms is important during pregnancy, continued support after giving birth is important. Postpartum can bring its own risks to stay aware of in terms of body image and emotional changes.
After giving birth, there may be a risk of relapse or increase of eating disorder symptoms. This may be a result of the pressure many mothers feel in our body and appearance focused culture to lose weight and return to their pre-pregnancy body and weight. Accepting the changes in weight or appearance can be distressing to a new mother who has a history of an eating disorder.
According to one study, 1 in 5 new mothers will suffer with a maternal mental health disorder, such as postpartum depression. Symptoms may include a depressed mood or mood swings, excessive crying, difficulty bonding with your baby, overwhelming fatigue or loss of energy, irritability and anger, and feelings of hopelessness. These symptoms usually develop within the first few weeks after giving birth, or during pregnancy, or even up to a year after birth. Struggling with postpartum depression can cause an increased risk of relapse of disordered behaviors.
If you or a loved one is pregnant and suffering from an eating disorder, take the first step today and talk to someone about recovery or start by learning about the eating disorder recovery programs we offer.