Then it changes more. You’re not sure how you feel about it. Those of us who have gone through recovery know these symptoms. We know the anxiety, the distress that they bring as we let go of eating disordered behaviors and finally cede to the advice and recommendations of our health care professionals. We know the mixture of pride and pain that goes into the necessary release of control over food and exercise.
In spite of my experience with both pregnancy and recovery, as I navigate through my second pregnancy, I do not find that dealing with these physical and emotional changes has gotten much easier. Even though I love being a mom and am forever thankful that my body has allowed me to get pregnant at all after the abuse she has taken from my eating disorder, I often find myself triggered to fall back into disordered behaviors, particularly when others notice that my body has grown.
Just like in recovery, comments about my expanding body, even if those comments imply that the change is “healthy,” cause a volcanic eruption of negative self-criticism and self-doubt.
The other week, I again confronted such an onslaught when my husband and I met with our prospective doula for the first time. Since she knows that I have struggled with an eating disorder, she asked how nutrition was going. I replied that it was ok, emphasizing that the baby was healthy but admitting that I still struggled not to restrict. I explained that my nutritionist had strongly urged me to push intake because she feared that the baby might be stripping from my lean muscle tissue and organs.
My doula bluntly responded: “Well, you don’t look underweight.”
First, I cringed. Then, I added her comments to the growing list of body observations others have made as I have progressed through pregnancy.
“Wow! You’re not even five months! You’re really big!” said my sister’s mother-in-law when I was seventeen-weeks pregnant with my son, who is now two and a half.
“Look at you! Your belly is really sticking out!” exclaimed my son’s caregiver one morning earlier this spring, before I went to work.
“My goodness! You’re getting big!” said a neighbor a month ago.
Always, the comments have been delivered by women. Always, I have to weather a storm of disordered thoughts afterward, reminding myself that every woman and every pregnancy is different. I have to cut down any shame that I may feel about my growing body and try to replace that shame with pride in my ability to carry and nurture not only my own life but also the life of another.
I know that these comments are not meant as critiques. In the case of my doula, who is aware of my eating disorder and of my struggles in recovery, I knew that she did not intend her remark on my weight to be derogatory or offensive. I knew it would not be a compliment if she were to say I looked underweight, especially during pregnancy. I also knew that my doula didn’t have the information on body composition and cell integrity that my nutritionist uses to assess my nutritional health.
Her remark, which equates anorexia with being underweight, shows her ignorance of the effects of food restriction on metabolic rate, which are not limited to weight loss.
Still, the anorexic in me felt like not being “underweight” was the worst insult she had heard in a long time. She wanted to shrink into her chair, to hide her growing belly into her baggy sweatshirt. I had to remind her, from the standpoint of recovery, that I was happy to be of normal pregnancy weight. I had to remind her that I had worked hard to restore my bone health in recovery and that I did not want to sacrifice all of the gains I had made. I had to remind her that I wanted to be healthier both for myself and for my five-month-old fetus.
The overwhelming focus placed on the body during pregnancy is, of course, difficult for women with a history of eating disorders. Instead of supporting a woman during this time of intense emotional, spiritual and physical transformation, comments on weight gain place the focus completely on the physical. They fuel the disordered drive to compare one’s body to the bodies of other people. They feed the disordered voice that judges one’s body as abnormally marked or flawed, the voice that places the physical in the center of life.
Whether or not we experience pregnancy, as people who go through recovery, we have a choice on how we handle these comments. We can educate those who make them on our recovery process. We can explain that it is never helpful to focus on weight gain or loss, as doing so dismisses the major emotional shifts that independently accompany the processes of recovery and of pregnancy. Or, we can focus on our own internal reactions.
In my experience, I haven’t yet found the energy to respond to body comments with words. But, I have learned that if I take a deep breath and focus on my reception of the comment, I can have a healthier experience and redirect the urge to engage in my disorder.
Instead of making recovery or pregnancy about weight, by focusing on how we are feeling, on how we experience change from the inside, I believe we can build stronger support systems during these times of intense physical and emotional change. We can help heal the emotional depression that often accompanies eating disorders and pregnancy. We can facilitate conversations about well-being and help to undo any shame that women who experience any and all body changes may feel. Rather than experience our emotions in isolation, we can weave together a network of strength, relying on each other in these times of intense, miraculous change.
Like recovery, the most superficial signs of pregnancy are body changes and food cravings.
But the most meaningful outcomes are a deeper connection to life and a revision of the way in which we identify ourselves and our roles in this world.
That is where true growth begins.
Beautifully articulated article. Thank you so much for writing this and sharing it with us. Now if only all physicians and especially obstetricians were required to read it. 🙂 I love and appreciate all of the information shared on dealing with eating disorders during pregnancy. However, as my husband and I struggle with infertility I find myself searching and searching for more information on this topic. I know my century long battle with an eating disorder and over-exercising is impacting my ability to become pregnant. I also know that many like me struggle with infertility. I really wish it was something that was talked about more and was wondering if there were any chance you (or someone) could do a post on this subject. Thank you so much and congratulations and best of luck for the remainder of your pregnany!