can pregnancy trigger an old eating disorder?

Ask the expert: I recovered from an eating disorder but worry pregnancy could trigger it. How can I prevent that?
by Jodi Rubin, ACSW, LCSW, CEDS

(reprinted with permission from Seleni Institute, a nonprofit organization based in New York City that provides care, information and research support central to women’s reproductive and maternal mental health and well-being.)

Pregnancy can be a time of excitement and joy, but it can also be a time of uncertainty and anxiety about your changing body – especially if you’ve battled eating disorders in the past. Recovering from an eating disorder is a long, hard process, and it’s normal for women who have been through it to worry about having renewed struggles with food or body image.

Even if you are at a happy and healthy place in your life, the changes of pregnancy – weight gain, morning sickness, diet and exercise adjustments, not to mention the responsibility of caring for another human being – are bound to be at least a little stressful.

You may also face pressure from friends, family, physicians, and yourself to look and feel a certain way, to gain enough (but not too much) weight, to have the perfect pregnancy, and to get your pre-pregnancy body back as soon as possible after giving birth. You can’t ignore or eliminate this pressure, so the best thing you can do is to be ready for it.

Shore up your support system and surround yourself with healthy, positive resources. This could include finding an ob-gyn who has experience with eating disorders and will take a more sensitive approach when discussing things like your weight and body image. It may mean avoiding magazines or television shows that promote unrealistic expectations about pregnancy and weight loss. And it’s important to educate yourself about what’s healthy and “normal” during pregnancy, so you don’t get too caught up in all the unsolicited advice or criticism you’re sure to receive.

It might also be helpful to see a therapist at least once (and possibly on a regular basis) to check in about how you’re feeling. Even if your anxiety is totally normal, it can still help to talk with someone about what you’re going through. Include your partner or spouse in conversations about how you’re feeling, even if you’ve never discussed your eating disorder before. It’s important for you to articulate your concerns – whether you have specific requests (“Can you not make jokes about how huge big my belly is getting?”) or you just want reassurance and an open line of communication.

As you know, an eating disorder is a symptom of underlying issues. If you’ve already dealt with the underlying issues, food won’t have the same control over you that it used to. But you may notice that in times of high stress (and pregnancy is a big one) your focus on food starts to heighten, and you may begin thinking about it more than usual. Maybe you start skipping breakfast, restricting certain foods, or weighing yourself three times a week instead of once.

Be aware of those red flags, so you can understand what’s happening, get help, and make a conscious decision not to go down that road again.

How you deal with pregnancy has a lot to deal with how much work you’ve already done on accepting your body. When you’re at a healthy weight and pregnancy is something you’ve thought about long and hard, you should be able to enjoy this very beautiful time, knowing that your body is going to take care of itself – and your baby.