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Unhealthy relationships with food during and after pregnancy

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February 11, 2020

By Jenni Jacobsen, LSW

After going through pregnancy and giving birth to a child, it’s not a surprise that many women find that their bodies have changed. Some may desire to lose weight to get back to the size they were before becoming pregnant. In some cases, this can be entirely realistic, and women can use healthy methods to achieve weight loss. Unfortunately, however, there are cases where the desire to look a certain way after pregnancy can lead to an eating disorder.

What are eating disorders?

Eating disorders are mental illnesses that involve dysfunctional behaviors, thoughts, and emotions surrounding eating. People who struggle with eating disorders can become fixated on food, body weight, and body size, and in some cases, eating disorders can be fatal.

There are different types of eating disorders. For example, in anorexia nervosa, people severely restrict food intake and view themselves as overweight, even when they are dangerously thin. In bulimia nervosa, people go through episodes in which they binge eat and consume excessive quantities of food. They then engage in compensating behaviors, such as vomiting, laxative use, or excessive exercise to rid themselves of extra calories. People with binge eating disorder also consume excessive amounts of food and experience extreme distress surrounding their overeating, but they do not compensate for the extra calories by vomiting or other means.

These eating disorders are not uncommon among women. A 2019 study in the American Journal of Clinical Nutrition found that 8.4% of women will experience eating disorders during their lifetimes, and 2.2 % have experienced one within the past month. Eating disorders are especially common among young women, and they can occur during pregnancy and the postpartum period.

How common are eating disorders during pregnancy and postpartum?

During pregnancy, a woman’s body changes, as it expands to make room for a growing baby. Some women may find themselves succumbing to an eating disorder during this time.

According to the research, eating disorders are about as common during pregnancy as they are during a woman’s lifetime. For example, a 2013 study in European Eating Disorders Review shows that 7.5% of women meet the criteria for an eating disorder diagnosis in the early stages of pregnancy.

Unfortunately, eating disorders may be even more common during the postpartum period. One study, published in 2016 in the Archives of Women’s Mental Health, found that 12.8% of postpartum women met the clinical definition of an eating disorder.

What causes eating disorders during pregnancy and postpartum?

Eating disorders during pregnancy can center around concerns about weight and shape, and women who have a history of eating disorders may be more likely to experience them during pregnancy. For example, a 2007 study in the Journal of Psychosomatic Research found that women with a history of eating disorders were worried about weight gain during pregnancy. Among women susceptible to eating disorders, the weight gain and body changes that naturally occur during pregnancy can cause eating disorder behaviors to emerge.

Related: Managing your own expectations after birth

Other research, published in 2014 in the Norwegian Journal of Epidemiology, suggests that some pregnant women may become more dissatisfied with their bodies late in pregnancy. They may feel they have gained too much weight and desire to lose weight, especially if they have a history of an eating disorder.

Additional research suggests that there are certain factors that can cause or increase the risk of eating disorders during the postpartum period. According to the results of a 2013 study in the International Journal of Eating Disorders, the following risk factors are associated with postpartum bulimia nervosa and binge eating disorder:

  • Psychological distress
  • Relationship dissatisfaction
  • Higher BMI
  • Higher weight gain during pregnancy
  • Having bulimia during pregnancy

Based upon the research, relationship and psychological issues, as well as higher weight, can cause eating disorders to occur in the postpartum period. Women who feel they have gained too much weight during pregnancy may feel unhappy with their bodies and have a strong desire to lose weight after having a baby. Some may turn to unhealthy habits, such as binging and purging, using laxatives, or severely restricting food intake to attempt to lose weight. This is where eating disorders can begin.

How do I know if I have an eating disorder?

Eating disorders involve a preoccupation with weight, body image, and eating. If you find that you are worrying about your food intake and your body size to the point that it is interfering with your daily life, you may have an eating disorder.

Symptoms such as weighing yourself excessively, fixating on being extremely thin, basing self-image on body weight, severe food restriction, and a strong fear of weight gain may suggest that you are struggling with anorexia.

On the other hand, if you sometimes lose control over your eating, and you find yourself binging and then using extreme compensatory measures, like exercising for hours, forcing yourself to throw up, or taking laxatives, you may be struggling with bulimia.

If you feel you have lost control over your overeating and feel ashamed about the amount of food you consume, but you are not taking measures to compensate for the extra calories, you may struggle with binge eating disorder. If you have binge eating disorder, you may eat when you’re not hungry, or continue eating long after you feel full.

When should I be concerned?

If you are displaying any of the above symptoms of an eating disorder and you feel that it is having a negative impact on your health, it is probably time to get help. This is especially important during pregnancy and the postpartum period, when eating disorders can have serious consequences. For example, a 2014 study in the American Journal of Obstetrics and Gynecology found that having anorexia or bulimia during pregnancy was linked to babies being born at a lower weight.

Anorexia is known to be linked to a number of complications, including slower fetal growth, preterm birth, low birthweight, babies born small relative to their gestational age, and even perinatal death. Women with bulimia are at risk of having babies with a low Apgar score, and those with binge eating disorder are more likely to have hypertension, experience longer labor, and have babies that are excessively large for their gestational age.

It is imperative that women with eating disorders seek help early on to reduce their risk of complications during pregnancy. If you are having symptoms of an eating disorder, talk to your OB-GYN about your concerns, and he or she can refer you to an eating disorder specialist. Treatment for your eating disorder will likely involve psychological counseling, such as cognitive behavioral therapy, in which you replace your unhealthy thoughts and beliefs around food and body image with healthier feelings and behaviors. You may also undergo nutrition counseling to learn how to nourish your body with the foods needed for optimal health and wellness.

Related: The 6 most important nutrients your postpartum body needs

If you’re experiencing an eating disorder during pregnancy or after giving birth, know that you are not alone. There is treatment available, and it can help you to recover and enjoy life as a new mother.

Sources:
https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml
https://academic.oup.com/ajcn/article/109/5/1402/5480601
https://onlinelibrary.wiley.com/doi/full/10.1002/erv.2229?casa_token=19Yt25NphtUAAAA
https://link.springer.com/article/10.1007/s00737-016-0619-3
https://www.ncbi.nlm.nih.gov/pubmed/17719368
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4838406/#__ffn_sectitle
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3622173/#!po=2.41935
https://www.sciencedirect.com/science/article/abs/pii/S0002937814003366

Jenni Jacobsen is a licensed social worker with eight years of experience working with children and families. She holds a master’s degree in social work and is in the dissertation process for a PhD in psychology. She teaches college coursework in the areas of human behavior, mental health, addictions, family counseling, individual counseling, and social science research.

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