What to Expect When You’re Expecting in Recovery

Eating disorder recovery can be fragile at times, so it is common to be concerned about if and how your eating disorder may manifest during pregnancy. While pregnancy may trigger eating disorder thoughts about weight, size, shape, or body image concerns, it can also be a time of positive change.

Understanding Eating Disorders during Pregnancy

Many women can become pregnant while in eating disorder recovery. For those who become pregnant while they are suffering from an eating disorder, it is incredibly important to receive proper medical care for both your eating disorder and pregnancy as soon as possible. This care often involves the close support of an OB/GYN alongside an eating disorder specialist. Oftentimes, eating disorders can place pregnant women at a high risk for medical complications during pregnancy—especially if the eating disorder remains unaddressed. However, with proper care and support during pregnancy, it is possible to experience a healthy pregnancy and eating disorder recovery.

Eating disorders may manifest differently in pregnant individuals but they often align with warning signs and symptoms for those who are not pregnant. These signs include:

• Little to no weight gain during pregnancy or the loss of weight
• Restrictive eating or bingeing
• Purging
• Negative thoughts about self and body-image
• Fear of gaining weight and changing shape
• Isolation
• Medical complications including dizziness, fainting, dry skin, GI issues, and more

For those in eating disorder recovery who are pregnant, pregnancy may bring up feelings of fear, anxiety, or it may trigger old eating disorder thoughts. Because of the potential vulnerability of recovery during pregnancy, it is important to be aware of relapse symptoms and ways you can be supported.

Eating Disorder Relapse Signs

Eating disorder relapse is not uncommon. One of the best ways to combat relapse, especially a long-lasting relapse, is to be aware of warning signs of an impending relapse—and to seek help. Warning signs include:

• Increased concern about body image
• Fear or anxiety around food
• Eating disorder thoughts like calorie counting
• A preoccupation with weight
• A change in eating habits
• Withdrawal or social isolation

If you are worried you are on the verge of a relapse or are currently relapsing into eating disorder behaviors, seek professional care as soon as possible. Getting eating disorder support can help you regain control and put you back on track to recovery.

What to Expect During Pregnancy

While it is impossible to anticipate everything that happens with pregnancy, there are a couple of set changes to expect. These include varying emotions and body-related changes like weight gain and a new body shape.

Everyone’s pregnancy will be unique to them. While some changes in pregnancy are common, there are also changes specific to each person. By understanding that pregnancy will be a unique experience to you, you can plan for and create a successful pregnancy.

How to Cope with Pregnancy Changes

Body Changes and Weight Gain

Weight gain and body changes during pregnancy are necessary to keep both the mother and child healthy. The additional weight comes from both the baby and the extra fluid and additional food intake needed to support both the mother and child. The additional weight and fluid retention allow for proper circulation and growth for the baby, keeping both mother and child healthy and thriving.

While weight gain is vital to a healthy pregnancy, it can be challenging for those in eating disorder recovery. When an individual struggles with restrictive eating, purging or bingeing, it can be hard to break those thoughts and patterns during pregnancy. For those in eating disorder recovery, weight gain is often a common point of fear, anxiety, and distress.

Not only is an individual’s body changing, but it’s also common for those around the individual to comment on their pregnancy. Phrases like, “You barely look pregnant” or “Look how big your belly is!” can be extremely harmful to those in recovery.

To combat the negative thoughts and feelings that body changes during pregnancy can bring up, it’s important to have a plan and a support system. That support system can include your doctor, therapist, dietitian, family, friends, and more! Some other ways you can support yourself and cope with body-related changes include:

1. Make a list of all the reasons why your weight gain is important. Examples can include the fact that your weight gain supports your baby’s health or that your body is changing because it has the ability to bring new life into the world. When you are feeling down or having trouble coping, you can refer to this list to remind you why these changes are important.
2. Talk to a friend that understands. If you have people in your life with similar experiences, reach out for support. Sharing stories and experiences can be incredibly healing.
3. Write a gratitude list to your body. Start with, “I’m thankful for…” or “I’m glad my body is…” and list what resonates with you. While we may not always love our bodies, it can be helpful to find parts that we are grateful or appreciative of.
4. Seek professional help. If your thoughts about body image, weight, and food are becoming disordered, it’s crucial to you and your baby that you receive specialized support as soon as possible.

Emotional Changes

It’s no secret that pregnancy can have an effect on an individual’s emotions. You may feel sad when you least expect it or teary-eyed at the drop of a hat. Thanks to the fluctuating hormone levels during pregnancy, that’s normal. If you are feeling a bit off, disconnected with your emotions, or unable to control how you feel, try self-soothing with the following:

1. Treat yourself to something relaxing. This could mean taking a quiet bath, getting a massage, or reading on the couch. Remember to do this intentionally and to be present. If you need a reminder, you can say to yourself that you are doing this activity because you deserve to be content and relaxed despite everything changing around you.
2. Change your scenery. Sometimes when we are struggling with negative moods, our surroundings can make a difference. If you are feeling blue at home, tidying up, opening the blinds, or lighting a candle may lift your spirits. For a bigger boost, visit a local conservatory (which are usually free!), take a mindful walk in the sun, or visit an art museum.
3. Don’t apologize. When we aren’t sure what’s happening with our emotions, it’s common to want to apologize and change our feelings. Keep in mind that your feelings are there for a reason and that it’s okay to feel them! You never have to apologize for how you are feeling, so work to accept how you feel.
4. Seek professional help. If you are feeling anxious, depressed, or unwell, it’s important to seek professional mental health care.

Worry or Fear

Pregnancy is a big life change. It’s normal to feel some fear, hesitation, or anxiety around it. When you are hit with worry, try to think critically about what you are actually feeling and work to reframe it.  Some examples of processing negative thoughts are below.

• “I am scared of weight gain.” The underlying emotion of this worry may be rooted in disordered eating, fear of other’s judgments, or negative self-perception. This is a common pregnancy concern. When this thought comes up, try to replace it with something positive like, “I am thankful that my body is able to change and expand to protect and nurture my baby.”
• “I’m afraid I won’t be a good parent.” It can be challenging to imagine yourself as a parent and you may worry that you are not going to be a good parent. Or, you may think you don’t have the tools needed to be a good parent. These feelings can stem from a fear of failure, disappointment, or may even tie back to your own childhood and upbringing. When these feelings arise, try telling yourself, “I am going to be a great parent. I am capable of love, which is the most important skill I can have. If I truly do not think I have the skills necessary to raise my child, I can reach out for support or find ways to gain those skills.”
• “I don’t think my body will be the same after I give birth.” If you are anxious about how pregnancy will affect your body, that’s normal. Instead of focusing on what your body is doing “wrong,” focus on what it’s doing well. “My body is doing what it needs to do to keep me and my baby healthy. After I give birth, I will let my body guide me. While my body may change or feel different, it is still my body and I can find things to be thankful for.”
• “What if I don’t connect with my baby?” Some parents can experience postpartum depression after giving birth and it can be a point of worry for pregnant mothers. As stated by the Mayo Clinic, “Postpartum depression isn’t a weakness or character flaw, it’s simply a complication of giving birth.” Luckily, postpartum depression can be treated and prompt care can assist in the management of emotions and help mothers bond with their babies. So, if you are concerned about not bonding with your child, reassure yourself that if that is the case, it’s okay and that you can receive treatment that is specifically aimed at creating a bond with you and your child.

Pregnancy during recovery can be scary, but it can also be a time of great personal growth and change. If you are pregnant and experiencing eating disorder thoughts or behaviors, it’s vital to reach out for support right away. The Emily Program is proud to offer eating disorder recovery support to mothers in all stages of their lives. You can contact The Emily Program by calling 1-888-364-5977. To all the mothers who have lost their children or are struggling to have children, we see you, we support you, and we are here for you.