According to the American Pregnancy Association, women should gain anywhere from 15 to 40 pounds throughout their pregnancy, depending on their individual BMI. This seems to be a widely understood side effect of the pregnancy journey.
But hearing how pregnancy changes the body and experiencing it for yourself are two completely different things. Sure, while beginning to put on weight, a dip in self-confidence is quite possible and even normal. But for a woman who is particularly conscious about her weight or has wrestled with body image issues in the past, severe panic can ensue as the number on the scale begins to climb. If obsession with baby weight begins to take precedence over health, a pregnant woman can actually develop an eating disorder without anyone knowing it.
In the hopes of bringing awareness to this very real yet rarely discussed issue, mother Vanessa Olson shared her story with SheKnows.
One mother’s battle
When Olson was 31, she and her husband were delighted to find out that she was expecting their first child. She was ready for the pregnancy journey — or so she thought.
Olson had struggled with body image for as long as she could remember. In high school and college, Olson often found herself undereating and overexercising. She would take laxatives when she felt she overindulged. She lied to family members about her behaviors to keep them at ease. Olson once spoke with a counselor who helped her become better acquainted with her unhealthy relationship with food, but Olson never categorized it as an eating disorder.
“I realized that it wasn’t just about how I looked, it was also about my need to be in control,” Olson said.
As you might have guessed, a human being growing inside of you while demanding obscure combinations of snack foods doesn’t really align with one’s desire for control. Pregnancy can quickly turn a consistent eating and exercise regimen on its head — and for some, this can be terrifying. It was for this reason that the newly pregnant Olson began to have old urges.
In the two weeks between her first and second pregnancy appointments, Olson was hospitalized for dehydration, during which she lost 6 pounds.
“It made a tiny voice speak up that I hadn't heard in a while, since before I met my husband, and it said, 'Huh. Maybe I can lose weight through this,'” Olson said.
This was the start of it all. She began to starve herself again.
Women who have suffered from eating disorders in the past are more likely to experience symptoms again after becoming pregnant. In fact, 60 to 70 percent of eating disorder sufferers will relapse during pregnancy.
Despite the fact that she was eating for two, Olson began averaging 600 to 800 calories a day. She lied to her family about when she was hungry and avoided social invitations that centered around a meal. Olson weighed herself incessantly and chose to withhold food if she gained even a 10th of a pound.
“Each doctor’s appointment, I both dreaded and looked forward to stepping on the scale. If I gained weight, I cried all the way home. If I lost weight, I was elated."
Olson stands with the 7 million women in America who have been diagnosed with eating disorders, cases of which peak during childbearing years. The more common of these disorders are anorexia nervosa, which involves starving the body of food and nutrients, and bulimia nervosa, which is bingeing on large quantities of food followed by a period of purging. But eating disorders in pregnant women can create other dangerous behaviors, such as avoiding social events, canceling doctor’s appointments and choosing to overexercise.
What effect could an eating disorder have on the baby’s health?
When she arrived at the hospital to have her baby, Olson weighed only one pound more than her first doctor’s appointment. Luckily, Olson’s daughter Alice was born healthy and strong, albeit 10 days late, and weighed 6.5 pounds. But this isn’t always the case. According to the National Eating Disorders Association, babies of mothers who suffered eating disorders during their pregnancy terms may have developmental and respiratory issues and be born with a low birth weight.
During pregnancy, the growing baby essentially takes whatever it needs from the mother, including any and all of her water and nutrients. If a mother doesn’t consume enough to feed herself and the baby, she will find herself becoming malnourished and dehydrated and may even develop heart irregularities.
Delivery can also be impacted by an eating disorder. Pregnant women with eating disorders are more likely to have more difficult labor, leading to more cases of Caesarian section births. Due to the bodily stress of malnutrition, women may find it hard or impossible to breastfeed their newborn.
So… why is this happening?
It could be due to false expectations. The media works to instill the idea that pregnancy can be glamorous (ahem, Beyoncé) and that gaining baby weight is optional. Celebrity women somehow fit into their skinniest of skinny jeans until Month 9 of their pregnancy, and just moments after giving birth, the stars seem to have their slim figures back and better than ever.
These images, which are plastered on magazine covers and across all social media platforms, can cause women to wrongfully believe that they too must have similar pregnancies. This may lead pregnant mothers to engage in excessive dieting and exercise.
“If we weren't bombarded with images of what we should look like, I might never have started down this path in the first place,” Olson told SheKnows. “I might never have used food as a way to control my life.”
The early symptoms of eating disorders in pregnant women oftentimes go unnoticed. In Olson’s case, her eating disorder continued unquestioned for seven months. After repeated appointments of Olson losing weight, her doctor finally spoke up. This leaves us wondering: Why didn’t her doctor step in earlier?
According to Dr. Ovidio Bermudez, the Eating Recovery Center’s chief clinical officer and medical director of child and adolescent services, symptoms of eating disorders may be difficult for even the most alert clinician to identify on their own.
“Any pregnant woman can experience nausea and vomiting,” Bermudez told SheKnows. “Because it’s a time when weight gain is expected, weight loss may not be a marker of eating disorder behavior, but rather insufficient weight gain in timing with the pregnancy.”
The great variation in the health and physical changes within every woman’s pregnancy could account for this time lag, but it truly comes down to communication with one’s obstetrician.
There are certainly medical and psychiatric resources available to pregnant women who are experiencing these detrimental thoughts and behaviors, but women are often fearful of talking about or embarrassed to confide in someone about their eating habits. Treatment cannot begin unless a woman is willing to reveal her internal struggle to family, friends or medical professionals.
What can be done for pregnant mothers in this situation?
“For women who have struggled with eating disorders in the past, a pregnancy is a time when special attention should be paid to their psychological well-being and physical health,” Bermudez said. “Seeking support during this time may be wise.”
After sharing her struggles with her doctor, Olson was referred to a psychiatrist. Together, they worked to uncover and truly understand the root of her eating issues: generalized anxiety disorder. Through these difficult discussions, Olson was able to begin to deal with her anxiety in a healthy way and begin to take steps toward recovery.
“I could ride in cars without panic attacks. I could see people. I could get dressed without becoming overwhelmed with the size of my growing belly. I was able to stop asking my husband if he loved me and if he still thought I was sexy,” Olson recalled.
These conversations were not easy for Olson; she didn’t feel a connection with every doctor, and family members didn’t always know what to say. But the decision to communicate created a better relationship with her baby and worked to preserve her positive eating habits into the future.
“I had a girl, and I desperately wanted to not pass on or model any of these behaviors to her,” Olson told SheKnows. “When I look at Alice's sweet, innocent face, I know that I have to be that strong, radiant woman for her and for all the girls in her generation. That's what we need to do now.”