Eating disorders during pregnancy are rarely discussed at OB appointments, but theyâ€™re not uncommon (a 2014 Norwegian review of studies surrounding women and eating disorders found that eating disorders in pregnancy are â€œrelatively commonâ€ and may cause health risks for both mother and baby; some experts hypothesize one in twenty women suffer an eating disorder while pregnant). Bottom line: They should definitely be a topic of conversation between patients and health care providers, especially if a pregnant person has a history of disordered eating. â€œFor women who have struggled with eating disorders in the past, a pregnancy is a time when special attention should be paid to their psychological wellbeing and physical health. Seeking support during this time may be wise,â€ says Ovidio Bermudez, MD, a psychiatrist and Chief Clinical Officer at Eating Recovery Center , an eating disorder treatment center in Denver, CO.
And the postpartum period is one where a new parent can be equally vulnerable: Stress, exhaustion, and pressure to bounce back to a pre-baby weight can all exacerbate disordered eating behavior, even if the person hasnâ€™t exhibited symptoms in years. But whatâ€™s particularly worrisome, says Bermudez, is the fact that many moms may hide their eating disorder because theyâ€™re ashamed. â€œA woman may feel like sheâ€™s not a good mom because sheâ€™s struggling, when itâ€™s an illness, itâ€™s something bigger than her and has nothing to do with her self-control or her parenting skills,â€ says Bermudez. Thatâ€™s why itâ€™s crucial to get help from an expert. If you are struggling with an eating disorder and are in need of support, please call the National Eating Disorders Association Helpline at 1-800-931-2237. For a 24-hour crisis line, text â€œNEDAâ€ to 741741.
Here, writer Anna Davies shares how disordered eating became an issue when her daughter was six months old.
I walked into the elevator of the office building of my new job, bracing myself for comments and hoping my put-together outfit â€” sleek black dress, chunky gold necklace and four-inch heels â€” would distract from the bruise blooming around my black eye.
But I could tell, from the sidelong glances given to me by other people in the elevator, that it hadnâ€™t. By the time I got to my desk, Iâ€™d crafted a story.
â€œLucy kicked me in bed,â€ I said, referencing my seven-month-old daughter. My coworkers laughed â€” I worked at a company that made baby products, there were plenty of other parents on staff: They got it.
It wasnâ€™t the truth. The truth is, I had given the black eye to myself. I had made myself throw up that morning, and the force of the vomiting had caused blood vessels in my eyelids to rupture. I learned that from the ophthalmologist I visited the next day, who had asked me if Iâ€™d recently had a bout of the flu. I lied and said yes.
But I knew my eye was the least of my problems. I was anxious and stressed and exhausted as a single new mom, and, to cope, Iâ€™d been purging in the bathroom. I would do it while my daughter was in her crib, running the shower so she couldnâ€™t hear. I felt guilty doing it as a parent â€” after all, the last thing I wanted was to model disordered eating for my daughter as she grew older â€” but I couldnâ€™t stop.
I had been dealing with disordered eating since I was in my late teens, and by my twenties I was purging multiple times a week. I tried seeing a few therapists, but none were the right fit, and I was surprised at the lack of knowledge that some of the therapists I confided in seemed to have about disordered eating patterns (one told me it â€œwasnâ€™t like I was that skinny, anyway,â€ and another tried to psychoanalyze my purging patterns, convinced it had something to do with my relationship with my mother.) I tried to manage my disordered eating on my own, and by the time I was 28 and training for a marathon, I stopped completely because I was afraid of the ramifications purging, combined with heavy exercise, would have on my body. As I became more interested in training for different races and trying workout challenges, I began to develop a more positive relationship with my body. By the time I was thirty, I was convinced that my purging days were behind me.
And then I got pregnant. I was worried that my disordered eating might become a problem as my body changed, and I tried to bring up the topic with my OB. On the first office visit, I told her I didnâ€™t want to see my weight. While she was okay with letting me look away from the displayed number, over time, it was clear she didnâ€™t understand that my request came from a deeper place than vanity. One time, in my second trimester, she scolded me for gaining seven pounds. I burst into tears on the exam table â€” the only time during my pregnancy I cried.
The truth is, I had given the black eye to myself.
â€œItâ€™s okay, I know how it feels,â€ she said, awkwardly trying to console me, even though I was pretty sure she didnâ€™t understand at all. All I wanted to do was run to the bathroom and vomit. The only thing that stopped me was the fact that it wasnâ€™t just my body anymore.
I was too afraid to ask my OB for a referral for a therapist; as a single mom, I already felt like I was under so much scrutiny. I didn’t want my OB to think I couldnâ€™t handle the challenge.
I didnâ€™t purge during my pregnancy. It wasnâ€™t until my daughter, Lucy, was six months old that I felt the urge again. And while I wasnâ€™t 100% satisfied with my post-baby body, the urge was anchored in so much more than body image. I liked the control I felt when I purged; liked the feeling of an empty stomach. I never binged, my purges could occur after any meal or no meal at all. I was stressed about making money, stressed about finding a job, stressed about being a good parent, and purging felt, weirdly, like a form of self-care. It was something that could make me feel better, fast.
But when I got the black eye, I realized things needed to change. This time, I was verycareful about which therapist I decided to work with. Before, anyone who took my insurance and worked within a five block radius of my office was fine. This time, I asked other new moms for recommendations for therapists who specialized in postnatal depression or postnatal anxiety; while I wasnâ€™t sure I had either, it was imperative the therapist I spoke with had extensive experience with new moms. Once I had a few recommendations, I asked about how their eating disorder expertise: I wasnâ€™t sure I would be able to stop purging right away, and I wanted to make sure that a therapist I worked with would help me figure out a way to stop that wouldnâ€™t feel overwhelming. I also wanted a therapist to understand the pressure I put on myself â€” that I already felt so guilty for purging; I needed to feel like someone was in my corner.
Eventually, I found someone. Instead of focusing on not purging, I began focusing on the stressors in my life. One of the huge ones was my job â€” I began looking for new positions and left that one after a few months. I also had been putting a ton of pressure on myself to do everything perfectly. I didnâ€™t want people to think I was struggling as a single mom, so I tried my hardest to make it look like everything was easy to me â€” even if it wasnâ€™t. For example, one time, when my new mom friends and I planned a potluck barbeque, instead of offering to pick up napkins or tableware, I volunteered to bring desserts. I made five desserts that day while my daughter played in the kitchen, all for the I could never do what you docompliments.
And that was the biggest takeaway from therapy: That I didnâ€™t need to prove myself, and thatevery parent â€” single, married, whatever â€” needs help sometimes. I began asking friends to watch Lucy, stopped trying to be Supermom when it came time to plan the playdates, and also confided in my friends when I was feeling anxious or stressed out.
Now, Lucy is two, and Iâ€™m so much better than I was. I donâ€™t see a therapist anymore, and I feel so much happier and at ease than I was that winter morning a year and a half ago. But Iâ€™m not â€œcured.â€ Iâ€™m very sensitive to conversations surrounding weight. Discussions of losing the baby weight make me so angry; an innocuous message from a friend-of-a-friend asking me if Iâ€™m interested in her weight-loss coaching because she â€œspecializes in new momsâ€ led me to fire back an angry diatribe, explaining just how many new moms might be triggered by that type of language. I think eating will always be a fragile topic for me, and I know that if I do feel like I want to purge, itâ€™s a sign I may need to check in with my therapist and figure out whatâ€™s out of whack with my life.
Iâ€™m also open about just how hard all of this was to navigate, because I wish I had known back then that I wasnâ€™t alone, that new parenthood can bring up issues you thought were in your past, and that part of being a great parent is knowing when to ask for help.
Welcome to Mothership: Parenting stories you actually want to read, whether you’re thinking about or passing on kids, from egg-freezing to taking home baby and beyond. Because motherhood is a big if â€” not when â€” and it’s time we talked about it that way.