Navigating Pregnancy and Postpartum with an Eating Disorder

Pregnancy is often described as magical and transformative and while it certainly can be those things, when you're in eating disorder recovery, it can also feel overwhelming and triggering. Your mixed emotions aren't a sign of failure - they're a completely normal response to a complex experience.

EDs and Your Changing Body

Eating disorders (EDs) can affect anyone, regardless of age or background. For those assigned female at birth (AFAB), certain life stages can create heightened vulnerability to disordered eating patterns. These times often coincide with major hormonal and physical shifts - transitional phases where your body is undergoing big changes that can feel unfamiliar, out of control or even distressing.

There are three life stages that are particularly important here:

1. Puberty

As our bodies develop rapidly, changes in weight, shape and the start of menstruation can lead to feelings of discomfort or dissatisfaction. The societal pressure to fit unrealistic beauty standards can also be particularly challenging during this time.

1. Pregnancy/postpartum

Pregnancy is a period of immense change. Your body is growing to accommodate new life. Hormonal fluctuations, sleep deprivation and the emotional intensity of caring for a newborn can all heighten feelings of anxiety, depression or body dissatisfaction. The societal pressure to "bounce back" after giving birth can exacerbate existing struggles or trigger new ones. Regardless of whether you have a history of disordered eating, this period can be especially challenging.

1. Menopause

Menopause is often overlooked in conversations about eating disorders, but it is another stage of life that can deeply impact body image. Weight redistribution, decreased metabolism and changes in energy levels are all common experiences. These changes can reactivate or intensify disordered eating patterns. For more about menopause and eating disorders, see our blog post - Your Body Isn't Betraying You: The Menopause Conversation We Need to Have.‍

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Each of the three stages comes with its own set of challenges, but pregnancy and the postpartum period deserve special attention. These stages involve more than just physical changes - they encompass the deeply personal and emotional journey of transitioning into motherhood.

Pregnancy

Navigating pregnancy during eating disorder recovery brings a complex mix of emotions as your body undergoes numerous changes. Weight gain, something you may have once feared or avoided, is now medically recommended for your baby’s development. As your body grows, the shifting shape, changing clothing sizes and physical sensations may feel overwhelming and trigger old thought patterns. Even well-intentioned comments about your appearance can activate eating disorder thoughts you've worked hard to manage.

Pregnancy may also bring changes in appetite, food preferences, and nutritional needs. These changes can be particularly challenging if you've struggled with disordered eating in the past. Your safe foods may no longer bring a sense of comfort, or you may feel an increased hunger that is unfamiliar and frightening. Your body's changing needs might cause you to feel anxious or uncertain. It’s okay to feel this way. Everyone’s experience with pregnancy is different and your feelings are valid.

You might experience some of the following:

• Morning sickness that disrupts established eating patterns
• Food aversions to foods that were once "safe" or comfortable
• Increased appetite and hunger cues
• Confusion about appropriate nutrition amid changing needs
• Uncertainty about distinguishing between disordered eating behaviours and pregnancy-related food experiences

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Medical Monitoring and Weight Focus

Standard prenatal care often includes regular weigh-ins and discussions about weight gain that can feel triggering. While this information provides important clinical data for your healthcare team, the way it is delivered matters. You deserve care that acknowledges your history and presents information in a way that supports, rather than undermines, your recovery. It's okay to set boundaries around how your healthcare providers discuss weight and body changes with you.

You might request:

• Blind weighing (facing away from the scale)
• Not to be weighed (recommended only if not underweight or undernourished)
• Minimal discussion of the numbers unless medically necessary
• Focus on how you're feeling rather than how you look
• Validation of the emotional challenges you're experiencing

Remember that advocating for yourself is not being "difficult” it's an important part of your care and recovery.

The Postpartum Period: Often Overlooked, Equally Important

The postpartum period brings its own unique challenges. After giving birth, your body undergoes additional significant changes with weight fluctuations, healing tissues, stretch marks and dramatic hormonal shifts. You might be left feeling uncertain or disconnected from the body you once knew.

Meanwhile, the societal pressure for you to "bounce back" while simultaneously adjusting to the new routines and emotional demands of a new-born can feel overwhelming. This combination can feel emotionally draining and isolating, but you are not alone. One study found that over two-thirds of women struggle with feelings of body dissatisfaction in the postpartum period*. It is important to be kind to yourself during this time of immense change.

Common postpartum experiences that can affect your relationship with food and body include:

• Physical recovery from childbirth requiring additional nutritional support
• Breastfeeding changing energy needs and hunger signals
• Sleep deprivation affecting appetite regulation and emotional coping
• Identity shifts as you navigate your new role as a parent
• Limited time for self-care and regular eating patterns

Redefining Self-Care for Your Recovery Journey

When you’re navigating this period, if you have an eating disorder history, traditional self-care advice can feel frustratingly hollow. Another scented candle isn't going to address the complex emotions that surface when your body changes weekly, or when relatives make ‘well-meaning’ comments.

Self-care is about creating sustainable practices that honour both your physical needs and emotional boundaries during a vulnerable transition. This means something different for everyone, but here are some considerations:

• Give yourself permission to feel conflicted - you are allowed to have contradictory emotions. You may feel profound gratitude for your pregnancy whilst also grieving your changing body.
• Curate your information environment - consider switching to pregnancy apps that focus on developmental milestones rather than weight metrics and unfollow social media accounts that trigger comparison or promote ‘snapback’ culture
• Set boundaries for ‘well-meaning’ comments - you could say: "I appreciate your intention, but I'm working on valuing my body for more than its appearance."

Beyond the Physical

Pregnancy and parenthood involve much more than physical changes. This journey can also include:

• Reflecting on your own childhood experiences with food and your body
• Considering what values around eating and body image you want to model for your child
• Building a community that supports your recovery and parenting simultaneously
• Developing self-compassion practices that sustain you through challenges

These deeper aspects of the experience can provide meaningful context for the physical changes you're navigating. Recovery isn't linear, and pregnancy will likely bring both challenges and opportunities. However, these periods offer a unique opportunity to reconnect with your body as it works through this incredible biological process.

Finding Professional Support

If you're pregnant or considering pregnancy while healing from an eating disorder, connecting with the right support can make all the difference. You deserve compassionate care that honours both your recovery and your journey to parenthood. We understand the complexities of recovery during this life transition and can assist you in this challenging time.

Remember that by seeking support and continuing your recovery work during this transition, you're not only caring for yourself but also creating a foundation for your child's relationship with food and their body.

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References:

*Grajek M, Krupa-Kotara K, Grot M, Kujawińska M, Helisz P, Gwioździk W, Białek-Dratwa A, Staśkiewicz W, Kobza J. Perception of the Body Image in Women after Childbirth and the Specific Determinants of Their Eating Behavior: Cross-Sectional Study. Int J Environ Res Public Health. 2022 Aug 16;19(16)

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