Eating disorders such as anorexia and bulimia affect 3% of women in America, many of which are of childbearing age. It comes as no surprise that many women who suffer from an eating disorder may find themselves pregnant while battling their disease. Coping with an eating disorder alone is an incredibly tremendous task. Overcoming an eating disorder often takes years of psychological help and many times sufferers never truly recover from their disorder. When an anorexic or bulimic finds herself pregnant, the psychological damage resulting from the pregnancy, and the weight gain it entails, can be devastating to the woman’s mental health. For this reason, many women in this situation choose to terminate their pregnancies. The termination itself may have its own psychological impact on the eating disordered woman as well. But for women suffering from an eating disorder who choose to continue their pregnancies, the road is a long and difficult one.
If a woman has an eating disorder, shouldn’t it be impossible for her to get pregnant because of her weight?
No. This is not true. Although many women who do have eating disorders drop to extremely low weights that make their disorder quite obvious, not every victim of an eating disorder is that apparent. Eating disorders come in all shapes and sizes; petite, average, overweight and even obese women can all suffer from eating disorders, showing many of the same traits and characteristics as one another. Often times, it takes a woman years to get to the point that her disorder is suspected, or visible. Because of this, the woman may ovulate and have regular or even irregular menstrual cycles. Even if the woman has lost her period due to her eating disorder, all it takes is the release of one egg (also known as ovulation) for her to get pregnant if she has had unprotected sex, or contraceptive methods failed near the time of ovulation.
What happens to the baby if the woman continues to eat poorly throughout her pregnancy?
If a woman becomes pregnant while suffering from an eating disorder and continues to carry on the behaviors associated with her disorder, the effects on the baby can be devastating. The pregnancy can be lost at any point due to malnutrition and the inability of the woman’s body to nourish a pregnancy. The baby, if it survives may be low birth weight and suffer from physical handicaps, malformed body parts, poorly functioning organs and even mental retardation.
That sounds really bad. Why can’t the woman just eat normally?
In theory, that sounds like a simple solution, however, in practice, it’s not practical. An eating disorder isn’t usually just about being fat or a fear of gaining weight. An eating disorder is about control; power over one’s own body and mind. An ability to regulate and discipline yourself. Most women suffering from an eating disorder do not want to cause harm to their baby, and try to do their best to make sure they are eating right, but it can be very difficult. An eating disorder is largely psychological, and the habits and patterns this woman has developed from her eating disorder can be near impossible for her to break and the consequences of not maintaining the self-mandated level of control can be horrifying for her.
For example, if a healthy person has a snack of three cookies and a glass of milk, they typically think nothing of it. For someone suffering from an eating disorder, having eaten those cookies and milk is a sign of a loss of control; a loss of power and they often feel they must be punished for that loss, and make up for it somehow. This punishment is often self-inflicted and carried out by extreme amounts of strenuous exercise to burn off the calories consumed in the milk and cookies. The disordered woman may even force herself to vomit (also known as purging). Even if the woman has inflicted self-punishment on herself through purging or exercising, the guilt from consuming the calories in the cookies and milk can be too much for the woman to bear. She may end up extremely depressed, may harm herself, or even become suicidal; all over a glass of milk and three cookies. This is intensified in a pregnant eating disordered woman, because most of the time, she knows she should eat, and she usually wants to for the sake of the baby, but as soon as she does, those feelings of guilt and failure can become overwhelming, trapping her in a vicious cycle of failure and punishment.
What can the woman do to help herself?
If a woman is suffering from an eating disorder and finds herself pregnant, it is even more crucial that she seeks out the help of a professional with experience treating eating disordered individuals. It is also important that the woman begin seeking prenatal care and inform her caregiver about her eating disorder and the impact it is having on her and any concerns she may have for her baby’s health.
If the woman is worried about the cost of treatment and prenatal care, she may qualify for government funded health care while pregnant and should inquire in her state’s department of health and human services about how to apply for coverage.
Some women find that practicing visualization exercises when eating helped make it easier. Visualizing what specific part of the baby’s body that particular food was going to aid in development may make it easier on the woman. For example:
“These carrots are to help my baby’s eyesight.”
“This fish is to help my baby’s vision and brain development.”
“This meat is for my baby’s muscle development.”
“This milk and yogurt is for my baby’s bone development.”
“This cupcake is for my baby’s cute little baby leg rolls.”
Visualizing what each food will contribute to on the baby may help lessen the impact of consuming the food on the mother, by pulling the focus off of the mother’s own body, and placing it on the baby’s body and it’s needs.
What can I do to help her?
Be supportive. Do not try to force the woman to eat or guilt trip her into it. Odds are, she is already dealing with intense feelings of guilt already. Adding additional guilt and negativity to her plate may send the message that you are disappointed and upset with her, causing her to feel even more alone and isolated. It is important to encourage her to eat, reminding her of how precious her baby is and how he or she really needs his or her mother to be strong for them. Suggesting and encouraging visualization techniques, like the one mentioned previously, may be helpful. If the woman is not seeking psychological help, or seeing a prenatal care provider, it may be beneficial to suggest she find one, and even help her search for one. If she is worried about the costs of treatment and health care, be sure to let her know about your state’s health care coverage for pregnant women and how she can apply for this coverage. Most of all, be a friend and show support. Encourage her, and let her know that you are there for her no matter what. Let her know you are here to help, and you will do anything in your power to do so. She needs you now more than ever.