Pregnancy and an Eating Disorder

Having an eating disorder is one of the reasons that I thought I might never become pregnant. And it’s true that if someone restricts or binges & purges long enough, they can cause irreversible damage to their fertility. I thought I was going to be one of those statistics.

“Having an Eating Disorder can increase your chances of never being able to get pregnant, and the longer you have an Eating Disorder, the higher the risk that you will face some type of fertility problems.” [Source]

But here I am, unexpectedly expecting so I guess I am not one of those. However, that doesn’t mean that I am immune to some challenges that I’ll have to face during and after this pregnancy because I have an eating disorder.
Last Day of 1st Trimester

I was in a treatment center, an outpatient group and still see a therapist and dietitian. There is hope that people can recover completely from EDs, but that usually takes upwards of 7 years. I did gain back weight to a healthier level, but there are still thoughts that come crashing through my head when I least expect it. Okay, sometimes I expect them as well. (Stressful times trigger them.)

I told my midwife at my very first visit that I struggled with anorexia for years. I very clearly told them that I did not want to be told my weight. I don’t know my exact weight and don’t want to know it. I know my brain, knowing that number would probably upset me at this point in my life. I told my midwife that all I wanted to know was if my weight gain was on track or not.

Sometimes women who are pregnant do not tell their doctors that they have struggled with an eating disorder in the past. This isn’t information that should be held back! All women are at heightened sensitivity about their changing bodies during pregnancy, but this can spur a relapse in the ED. Please, make sure your whole team knows about your past if you are in this situation!

So they haven’t told me any specific numbers. But at my last appointment, she did mention that I hadn’t gained anything during the first trimester and that was probably due to being sick so much. She wasn’t concerned about that and said “we’ll make it up during the second trimester.” My husband was a little upset to even have that much mentioned to me. I guess I can see his point of view, but I do need to know if something isn’t on track as well.

But the eating disordered side of my brain heard what she said… and it was PROUD.

There are times where I think I might feel hungry, but I’m not entirely sure. It becomes a whole battle inside my head. (I envision it like some kind of chaotic mess out of Medieval Times or something, a big battle going on and everyone’s swinging, but after a while they all get so tired that nobody even knows what to do anymore.) And usually I end up feeling really queasy after a while, which is an indicator that I probably was hungry but then it becomes nearly impossible to choke something down.

My changing body is doing nothing for my self-esteem. My body image is dropping lower each day. Lots of women seem to enjoy this part, but I hate the way my chest has changed. The slight rounding on my tummy isn’t adorable to me, it’s just scary. Pregnancy has given me crummy acne and every one of those zits leaves behind a dark spot. I feel… well, homely.

Beyond pregnancy, I’m scared how I will react. I am planning to breastfeed, so I know I’ll have to eat even more to support both of us. I think my greatest fear lies within weaning, once I’m no longer responsible for supporting two people with my body, I fear the urge to restrict to an extreme will be back extremely strong.

“60 to 70 percent of eating-disorder patients experience remission during pregnancy. While the actual pregnancy can aggravate an eating disorder, the postpartum period can compound its intensity.” [Source]

We don’t plan on finding out the gender of the baby, but there is a part of me that feels like it’s a girl. (And kind of hopes that it’s a girl… but those are stories for another day.) But if it’s a girl, that also terrifies me.

“A woman with a sister or mother who has anorexia is 12 times more likely to develop anorexia nervosa and four times more likely to develop bulimia nervosa.” [Source]

People tell me to go ahead and eat whatever because I’m pregnant. But that won’t be the case after the baby is born.

“Dr. Diana Dell of Duke University adds that when these women were pregnant, society said it was OK for them to eat more and gain weight. “Once the baby is out, that cultural protection is gone. Plus, there is cultural pressure to regain the previous level of thinness,” notes Dell. Just think of all the post-baby photos of any celebrity who has recently given birth. Do they ever look like they’re even wearing maternity clothes a few months postpartum? For most women, it takes a while—sometimes up to nine months or longer—to lose all of their pregnancy weight.” [Source]

The fact that I can recognize these thoughts is good, it means that I’m much further along in recovery than I give myself credit at times. And I share these thoughts with the general public to not only educate people that this is a stressful time and many women do fall back into ED patterns because of pregnancy (most after pregnancy), but also as a way of letting people know that I may be fragile at times… and I need to remember to keep my lines of communication open. The support of family and friends is always essential in life, but when there is pain it becomes even more necessary. And those tend to be the times when I block it out the most. So I’m trying to remind myself that I do have a support network, I just need to use them!

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  1. If it helps, you’re in the part of pregnancy where you just feel sort of…bloated. It’s not obvious you’re pregnant to other people yet, and you feel nauseous when you don’t eat and nauseous when you do.

    In a few weeks, when you really start showing and you can feel the baby moving more, you might feel differently. I did, in both my pregnancies. I don’t have ED, and I didn’t exactly feel negative toward my first-16-weeks pregnant body, but both times I felt much more positive about my body once I *looked* pregnant and could feel the baby moving all the time.

    Also, you don’t actually need to eat more than an extra couple hundred calories a day when you’re nursing. So it’s maybe not as daunting as you think? 🙂

    Hang in there. I’m thinking of you guys often and keeping you in my prayers!

    • I hope that helps. Because like you said, right now I feel like I just look kind of bloated and I almost want to go around and point at my mid-section screaming, “Seriously, I’m pregnant okay. I know this looks different from my normal!” But then again, most people probably aren’t noticing it as much as I am either!

  2. Jill:
    First of all Congratulations! I saw your Curve Ball post but never saw the follow up when you announced you are pregnant.
    My son was very planned, right down to the month we wanted him to be born. I can’t imagine discovering I was pregnant when I wasn’t trying.
    Sounds like you are doing the right thing seeing your doctors and getting all your needs taken care of. Even more importantly, keep getting those needs taken care of after the baby comes! Accept help when it is offered and ask for help when you need it.

    Erin 🙂

  3. I wish I knew what to say to help support you. One of my closest friends suffers from ED and through that I’ve learned that it really isn’t about the food or the weight, it is about underlying issues and control. I just want you to know you have so much support and so many people care about you – hang in there!!! Let me know if I can do anything.

    • You are so sweet, thank you! And I’m glad when people realize it really isn’t about the food or weight. That education needs to spread so much wider!

  4. Jill, you are recognizing the issues and that is a victory.

    Change what you can….like..the acne. Use Murad or ProActiv. Works wonders and it will also help your self-esteem (I know this).

    You are smarter than you realize, I see so much wisdom in your posts about the “what if’s” and you are already working (in your head) to offset those thoughts and actions.

    We are here for ya!

    • Sadly, the information out there about what you can use for acne during pregnancy is just as wild and inconsistent as EVERYTHING related to pregnancy. Don’t eat this, do eat this. Don’t use that, do use that. It’s ridiculous!

      But since I’m smarter than I realize 😉 I’m using my common sense to find things that work for that! LOL!

  5. I think its great that you were upfront with your midwife and asked not to be told your weight. Make sure the nurses know, too. I know in my doctor’s office, they gave the option of standing on the scale backwards for those who don’t want to track their weight.

    You are doing better than you think you are, give yourself some credit. 🙂 Personally, I think you are going to be a great mom. I also think it’s exciting to not find out the gender (although now I can’t shop!). Dan/Jen didn’t find out on any of their children and we didn’t find out with our last. It drove everyone else nuts, but I think it made the whole process more fun, especially since it was an unplanned pregnancy.

    You are right in that you do have a wonderful support system between your online friends/family, your running family, and your “real” family. We’re here for you even if it’s just to listen.

    • I know I’m doing well… that’s what allows me to even write and share these things. So trust me, I am giving myself that credit!

  6. It had not occured to me the difficulty between being pregnant and having an ED would be. Sorry I am so dense. I still want to be happy and excited for this new baby however, I am now much more aware of the challenges you will be facing. We are always praying for you and your hubby but now I will pray with more intensity and greater knowledge.

  7. thank you for sharing your story. As someone who suffered from an eating disorder, I can understand feeling “proud” but knowing that it’s not good. Stay strong.

  8. i think it is incredibly bold that you are willing to be this open about so many things others would keep in! thank you so much for being willing to share so others can learn and understand. you are also amazingly strong to be working through all of this at the same time! im sending lots of positive thoughts your way to continue staying strong and working through all of the tough parts 🙂

  9. Firstly, CONGRATULATIONS!!! I can’t believe you’re going to have a baby!

    Second, I believe I’m on the reverse side of disordered eating (working on it!) and I have never been pregnant so I don’t really have much to offer except that you are so wonderfully brave. I remember when this was a topic you kept hidden and then revealed slowly. I think your struggles and successes are so important. You’re amazing. (and can I say beautiful?)

  10. I’ve been wondering about how your history with an eating disorder was affecting you during your pregnancy. I’m glad to have some more information to understand better. Pregnancy and having an infant can become stressful at times, particularly with wild hormones during pregnancy and post-partum. If stress is what triggers your negative thoughts, I hope you’ll stay proactive about getting whatever help you need to work through it. You’ve made great progress over the last few years and I think your post shows that you’ve got good momentum to overcome the challenges of pregancy to keep it up!

    I hadn’t really thought about the issues you mentioned with breastfeeding. I didn’t usually conciously think about eating more calories while breastfeeding, because I naturally felt more hungry, (although I did consciously drink much more). It was usually a reasonable amount to compensate the extra calories for keeping my milk supply right. As I reduced feedings, my body didn’t send me the signals to eat as much. But it sounds like you’ve got some “trust issues” with your natural signals. Not sure what the professionals recommend, but my thought was that you might be better off not counting the extra calories too closely while you breastfeed so you aren’t as tempted to restrict a specific amount when you wean. Of course, if you have to count calories to monitor that you are eating a healthy amount currently, that tactic might not work, but I hope you can find something that does. Weaning can be a long process depending on how long you decide to breastfeed. I reduced feedings periodically over 8 months with my second child. So perhaps that might help you gradually become accustomed to a post-breastfeeding diet that is healthy rather than have to suddenly restrict the extra calories.

    Was surprised to hear you weren’t going to find out the gender, since you say you normally like to plan out the future. But I agree that it is pretty exciting this way.

    • Yeah, I do like to plan… but I’m rather indifferent about planning baby stuff and Kevin is absolutely adamant about not finding out the gender. Thus the reason for our decision!

      I can’t count calories. It’s not wise for me. Part of my eating disorder, while restricting, I counted every calorie that I consumed and I weighed/measured all of my food. My recovery team and I have worked really hard to break those habits. But I absolutely have trust issues, because I actually turned off all of those natural hunger cues for a long time. Basically, the body gets to a point where it’s just conserving life… so it no longer puts forth energy to give you hunger cues because it’s using what little it has to keep your heart, lungs, brain and other essential organs functioning.

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