By: Jasna Veljkovic and Amy Vespa, Nutritionist

The other night as I got out of my shower, I stood on the scale in my bathroom and let out an aggravated sigh. “What’s wrong, Mom? Why do you look so worried?” my 13-year-old daughter asked me, witnessing my frustration. “This is how it starts,” I reprimanded myself silently and decided on the spot to change the universal narrative for the sake of my child. “Oh, I just realized I won’t have time to go for a pedicure before that wedding next week.” I quickly came up with a reasonable explanation that had nothing to do with weight. “I don’t like this nail polish on my toes.” Luckily, I am a good actress, and she bought it and offered to do my nails for me!

As a mother of a young girl about to enter her turbulent teens, I am consistently reading up on how to approach critical topics like weight issues and eating disorders.

Doing my research has made me increasingly aware of the severity of these very dangerous yet always present concerns and how prevalent they are. New mothers also often struggle with eating disorders, which can affect them and their babies.

The Causes

There is no definite answer as to what exactly causes eating disorders. It differs from person to person and can be a number of different things ranging from psychological, biological, and, most commonly, sociocultural factors.

Eating disorders, such as anorexia nervosa, bulimia nervosa, binge eating disorder, and orthorexia, are complex mental illnesses that can have serious consequences on the health of pregnant, postpartum, and breastfeeding women. We are all vulnerable to these disorders at any point in our lives, but pregnant and breastfeeding women can be especially at high risk due to the physical and emotional changes that come with pregnancy and motherhood.

Eating disorders can have a significant impact on the health and well-being of both you and your baby. These conditions are associated with a range of physical and psychological effects that can pose serious risks to maternal and infant health.

How does an eating disorder affect pregnancy?

Pregnancy, for example, can trigger anxiety and depression, which can exacerbate eating disorders. Additionally, as weight gain is a natural and necessary part of pregnancy, for women with eating disorders, this can be a significant source of stress and anxiety, or an unhealthy obsession with choosing the right foods.

Pregnancy and Anorexia Nervosa

Anorexia nervosa sufferers strive to control and limit the amount of food eaten, resulting in dangerously low body weight. Regardless of how emaciated they may become, they never think they are thin enough. Sadly, almost 1% of American women suffer from anorexia in their lifetime.

Women with anorexia nervosa who become pregnant may experience slower fetal growth, low birth weight, and an increased risk of preterm birth. They are also at an increased risk of developing gestational diabetes, pregnancy-induced hypertension, and pre-eclampsia because of low calories and imbalanced eating.

Pregnancy and Bulimia Nervosa

Bulimia nervosa is exhibited through unhealthy binge eating behavior. A sufferer will consume abnormally large amounts of food in a very brief time period and then follow this with purging. The purging is done either through induced vomiting or periods of starvation and avoidance of any form of nourishment, excessive exercising, or laxative intake. Statistics reveal that approximately 1.5% of American women suffer from bulimia nervosa in their lifetime.

Vomiting can cause dehydration, sore throat, stomach pain, tooth damage, gum disease, and ruptured esophagus in the mother. Using laxatives/diuretics can cause additional organ damage.

Bulimia nervosa can also lead to electrolyte imbalances, which can cause heart arrhythmias and other complications. This can lead to preterm labor, fetal distress, and an increased risk of cesarean delivery.

Pregnancy and Binge Eating

Binge-eating disorder (BED) is also an excessive unhealthy intake of food in a short period, but it is not followed by purging. About 2.8% of American adults suffer from binge eating disorder in their lifetime. Pregnancy is also a period of increased stress and anxiety for women with BED, which can worsen their condition.

Pregnancy and Orthorexia

Orthorexia is a newer term, but it is the most common form of eating disorder. It is estimated that 1-7% of women might be affected, but the rates are probably much higher because many people do not view this as a ‘disorder’ and don’t seek help. Orthorexia is an unhealthy obsession with healthy eating. It can lead to strict adherence to a restrictive diet, avoidance of entire food groups, and obsessive thinking about eating and food. It also impacts mental health because sufferers will avoid social situations when ‘healthy food’ might not be available, and it increases anxiety around eating and health. During pregnancy, orthorexia can lead to critical nutrition deficiencies when entire food groups are avoided.

How do eating disorders affect moms postpartum?

Are there any women out there who are ever happy with their weight?! In the postpartum period, dissatisfaction with body weight is quite common, even in women without eating disorders. Statistics show that in the first month after delivery, 75% of women are concerned with weight gain, and 70% of women are attempting to lose weight by as early as the fourth month postpartum! This increases the risk of developing an eating disorder or relapsing into an existing one.

Losing weight of more than 1 pound per week could potentially be very dangerous to your health and can affect your milk supply.

Breastfeeding with an eating disorder

Women with eating disorders may experience postpartum depression and anxiety, which can make it difficult for them to form a connection with their infants.

Breastfeeding while struggling with an eating disorder can also be challenging for the mom, as it can be difficult to meet the increased nutritional needs of both herself and the baby.

Anorexia nervosa can lead to a decrease in breast milk production, and moms with this condition may be advised not to breastfeed. Breastfeeding while experiencing bulimia nervosa can increase the risk of electrolyte imbalances and dehydration for both the mother and the infant. Moms with BED may be at an increased risk of developing postpartum depression and anxiety, which can decrease the likelihood of successful breastfeeding.

Babies

Eating disorders can also have a range of effects on infants. For example, infants born to women with anorexia nervosa may have a low birth weight and developmental delays. Additionally, these infants may experience feeding difficulties.

Infants born to women with bulimia nervosa may be at an increased risk of developing anxiety and emotional instability due to the unstable maternal psychological state. These infants may also experience developmental delays due to the impact of electrolyte imbalances on brain development.

Infants born to women with BED may experience feeding difficulties, an increased risk of obesity, and associated health problems.

What can be done?

If you are pregnant, postpartum, or breastfeeding, it may be particularly difficult to identify that you may have an eating disorder. Added to the massive hormonal changes your body is going through, weight gain or weight loss, loss of appetite, cravings, or any other peculiar eating patterns that are a common characteristic of this early part of motherhood, there is also the prevailing stigma surrounding eating disorders which make it hard to admit to a problem and seek help. Yet, it is important to seek help as soon as possible.  

Find support from professionals

Seeking help from a mental health professional who specializes in eating disorders is critical. They can help you develop coping strategies and provide tailored treatment options that are safe for you and your baby.

In addition, seeking help from a certified nutritionist or dietician (along with a mental health counselor) can help you learn more about what your body needs. They can also help you tailor an eating plan that gives you the best nutrition while also being comfortable for you.

Our consultants here at Leva can help you if you’re ready.

Focus on nutrition, not just weight

Rather than focusing solely on your weight, it can be helpful to concentrate on balanced and nutritious eating. Eating plenty of fruits, vegetables, whole grains, protein-rich foods, and healthy fats (fish, cheese, yogurt, nuts, avocados, some meats) can provide the nutrients you and your baby need to be healthy and strong.

Try not to avoid entire food groups (unless medically necessary) because each food group - whole grains, meat, vegetables, fruit - provides a range of essential nutrients. Avoiding entire food groups can cause nutrient deficiencies, especially at a time when your body needs lots of nutrients to recover from pregnancy and produce healthy milk for your baby.

Make sure to stay hydrated. Drink lots of water, tea, fresh juice, and hydrating foods (fruit, cucumbers, zucchini, lettuce, etc.). Dehydration can make you feel extremely tired, weak, anxious, depressed, and have headaches; when extreme, it can lead to severe health problems. Drink at least half your body weight, in ounces, each day.

It is likely beneficial to continue taking your prenatal multi to ensure you get all the vitamins and minerals you and your baby need.

Find safe ways to stay active

Exercise can be an important part of maintaining physical and mental health during pregnancy and postpartum. However, it’s crucial to speak to your healthcare provider about safe exercise options based on your current health status and eating disorder.

Practice self-care and coping skills

Battling an eating disorder is stressful, so it’s essential to prioritize self-care and engage in relaxation techniques such as yoga, meditation, or gentle stretching.

Set realistic goals

Setting small, achievable goals will help you build confidence and provide a sense of accomplishment. Celebrate small successes and be kind to yourself when you face setbacks.

Monitor your thoughts and feelings

Pregnancy and postpartum can be overwhelming. Women with eating disorders may notice negative feelings. Pay attention to how you feel and seek help if you experience negative thoughts.

In Conclusion

We are overwhelmed by images, messages, and beliefs on what an ideal female figure should be. The pregnant and postpartum body does not fit into that social “mold.” Postpartum, we may hold ourselves to unfair standards on how quickly we can achieve an unrealistic ideal after what our bodies go through to grow and nurture another human being. Be kind to yourself, take it easy, and take things slow.

Taking care of yourself and seeking professional help if battling an eating disorder is crucial, especially in the early days of motherhood. By focusing on nutrition, surrounding yourself with support, being kind to yourself, and taking advantage of helpful resources, you can overcome your eating disorder and achieve a healthy and happy pregnancy, postpartum, and breastfeeding experience for you and your baby.