23 Feb Body Image During Pregnancy and Postpartum
For many women, pregnancy and postpartum can trigger concerns with food, body weight and/or body image. For women with a history of eating disorders, the risk is greater and concerns can lead to obsessions.
Body Changes During Pregnancy & Postpartum
Aside from puberty, there is probably no greater time in a woman’s life that she will undergo extreme changes to her self-image than the perinatal period, which includes pregnancy and postpartum recovery.
During pregnancy, many women become more aware of the food they are eating, lifestyle habits, and their changing body shape, including weight gain. Weight gain is a normal marker of a healthy pregnancy. Your healthcare provider can help determine how much weight you should be gaining each trimester based on your pre-pregnancy weight and your body mass index (BMI).
Some women gain too much weight during pregnancy and then are faced with the challenge of losing excess weight in the postpartum period, while also caring for a newborn and adapting to changes in work, lifestyle or family routines. This is a lot to take on!
If you are overweight, consulting with your healthcare provider early in pregnancy will help determine how much weight, if any, you should gain during pregnancy. Small, healthy changes to your diet and lifestyle early in pregnancy will supply big rewards in the postpartum period, making your recovery from pregnancy and birth easier.
For some women, body changes during pregnancy and postpartum can trigger feelings of needing strict control over food intake, exercise, and a changing body. This is significantly higher for women with a history of eating disorders.¹
Eating Disorders and Pregnancy
Eating disorders include: anorexia nervosa (trying to maintain a below-normal weight through starvation or excessive exercise), bulimia nervosa (binge-eating followed by vomiting, excessive exercise or fasting), binge-eating (frequently eating unusually large amounts of food in one sitting and feeling that eating is out of control) and EDNOS (eating disorders not otherwise specified; cycles of restricting food and feelings of guilt and shame around food and body weight).
Most women with eating disorders fall into the EDNOS group, with features of disordered eating, often accompanied by other mental and physical health problems like substance abuse, anxiety and depression disorders, and Type 1 and 2 diabetes.¹
An example of EDNOS in pregnant women is sometimes called “pregorexia.” Pregorexia is not a scientific term but refers to a woman’s desire to control pregnancy weight gain through extreme diet and exercise. It’s been coined by popular media and sadly reveals how many women feel the internal and social demands to be thin and attractive even during pregnancy.
Warning signs of “Pregorexia” include:
- calorie counting
- eating alone or skipping meals
- excessive exercise
- expressing a “detached” or unrealistic view of pregnancy
- inability to separate the physical needs of the growing baby from the internalized need to be thin.
Unintended Consequences of Eating Disorders During Pregnancy
It’s important to know that if you’ve suffered from an eating disorder in the past, it takes time to heal your body. Women who have had an active eating disorder less than a year before conception are more likely to experience health issues during pregnancy or with the baby after birth.¹
In fact, eating disorders can affect fertility and the ability to get pregnant. Maternal eating disorders, anorexia and bulimia in particular, are associated with:
- bleeding during pregnancy that may result in pregnancy loss, preterm birth, or death of the baby soon after birth.²
Binge-eating disorders are commonly linked to:
- gestational diabetes, high blood pressure, growing a large baby that may require a c-section, and other pregnancy problems related to obesity.²
For the baby, adverse effects of restrictive eating disorders include:
- small size for gestational age
- microcephaly (abnormally small head)
- poor APGAR scores after birth (trouble breathing)²
- death soon after birth
- birth defects as a result of low folate levels from poor nutrition. Learn more here: https://www.cdc.gov/ncbddd/birthdefects/5-ways-to-lower-the-risk.html
Get more information on infant adverse health conditions.
Total Body Acceptance
The journey through pregnancy and postpartum can feel like going through puberty and back again. Emotional shifts in your self-esteem, self-image, and physical shifts in your body are all normal. Your body is strong and miraculous! It can be hard to ride this wave and find a neutral ground of total body acceptance, especially with societal pressures to meet a certain “ideal.”
This “ideal” may vary based on your culture and social background. If you suffered and recovered from an eating disorder in the past, you probably already know that pregnancy may be a trigger. Pregnancy is a time of “letting go,” allowing your body to grow and nourish your developing baby, which may be scary for women who have a history of severe restriction and control over their body image.
Another perspective is that pregnancy is a time of dedicated self-care, which means adopting or maintaining a balanced diet, exercise, stress and sleep routine. Investing in yourself through small, one degree healthful changes will eventually lead to a 180 degree change. Full recovery from eating disorders is possible! Here is some additional information about self-care during pregnancy.
If you are concerned about your risk for an eating disorder, take this screening tool by the National Association of Anorexia Nervosa and Associated Disorders. The organization also offers free peer support, which is critical for eating disorder recovery and for new mothers alike.
If you’re looking for reading material on eating disorders during pregnancy and postpartum specifically, check this out.
- Mantel, A., Hirschberg, A.L. & Stephansson, O. (2019). Association of maternal eating disorders with pregnancy and neonatal outcomes. JAMA Psychiatry. 2020;77(3):285-293. doi:10.1001/jamapsychiatry.2019.3664
- March of Dimes. (2016). Eating disorders and pregnancy. https://www.marchofdimes.org/complications/eating-disorders-and-pregnancy.aspx