Staying in Eating Disorder Recovery While Pregnant

When my husband and I were diagnosed with dual infertility and told that the only way we would conceive was through medical procedures, I was devastated. In that moment, and the weeks that followed, I felt that I would give anything to have a baby, and no sacrifice could be too big.

A short time later we began the process of fertility treatments. However, the drug I was put on to achieve ovulation caused such incapacitating headaches that we did not continue with the treatments. More devastation resulted.

Three months after stopping everything, we got our miracle. I was pregnant. Despite the hyperemesis that quickly set in, I rode a wave of ecstasy. How little did I know, though, that this longed-for miracle of pregnancy would revive old thoughts and struggles regarding my weight.

In my longing for a baby and feeling that I would give anything to have one, I had no comprehension that being given the very thing I longed for would result in yet another layer of my eating disorder recovery — a layer that went deeper and was more painful than any layer I had yet worked through. The painfulness of the layer came because this time it was coupled with the guilt that my coming miracle baby would even cause me to freak out about my weight.

It quickly became apparent that I was going to be very ill, at least through the first trimester. It also quickly became apparent that this miracle baby was at risk for being miscarried; shortly before eight weeks, I began to bleed. After the heartbeat was still able to be found on the ultrasound, I was ordered to bed rest until the second trimester.

This is when the battle began. Up until this point I had been a woman that worked out faithfully and ate properly. Now, I was put on restrictions so that I couldn’t even do a load of laundry, much less power walk four miles or do an intense pilates workout. The panic began to set in.

It got even worse. I would have these wonderful bouts of time in my day, usually in the afternoon , when the nausea and throwing up would cease. It was during these times that I ate. And ate. And ate again.

The food I craved was fattening food: chips with dip, Oreos, Pop-Tarts. . . I reasoned to myself that, since I was throwing up the rest of the time, even though the food was fattening I should be ok.

How wrong I was. When I weighed in at my 16 week appointment I was told that I had packed on seventeen pounds in my first trimester. I was crushed beyond words.

Crushed, and then completely panic-stricken.

All during the years of my recovery I had avoided the scale, focusing instead on healthy eating and exercise. While I vaguely knew what my weight was, as a general rule I would stand on the scale backwards at any doctor’s appointments in an attempt to deliberately avoid the temptation to be obsessed with the numbers on the scale.

That day in my OB’s office, the nurse, not knowing my eating disorder history and habit of avoiding the numbers on the scale, told me my weight as she wrote in my chart. ”Well, you started out at this weight, and now you’re at this weight,” she reported matter-of-factly. “That’s a total weight gain of seventeen lbs. You may want to slow it down a bit.” The number was staggering, and her words — humiliating. I began crying right then and there. The nurse was dumbfounded and quickly went to get my OB.

As I talked with my OB, she actually contradicted her nurses’ words and tried to reassure me that the weight gain was a good thing since I was “on the thin side before pregnancy anyway.” Her reminder that I was pregnant did not sink in. I was back in full-blown anorexic, I-am-fat-and-I-must-get-it-off-now mode. There was no consoling me. There was no reasoning with me. I cried through the rest of my appointment.

At the end of the appointment, my gentle and wise OB urged me to go back and revisit all the things that helped me with my eating disorder recovery in the years previous, and to begin implementing them into my life once again. Her calm advice helped me go from emotional back into my normally logical state of mind. On the hour trip home, I began to rehearse what it was I once did to overcome my anorexia with occasional bouts of bulimia.

For the previous five years, recovery had become such a way of life for me that it was an automatic process stay in it every day. Now, once again, I was going to have to purposefully think through on a daily basis, sometimes hourly, the steps of recovery and act upon them. I devised my plan, and once I got home I wrote it down in my journal –- which I then referenced every day for the remainder of my pregnancy.

First, I gathered up a support system. This is probably better described as a regathering of the old support system. I contacted my two best friends and my mentor and shared with them what had happened in the doctor’s office earlier that day. I shared that I felt both panic at my weight and an obsessive thought pattern to get it off, as well as the horrible guilt that I just wasn’t feeling in tune with my baby as a result of the panic. I asked them to pray for me and hold me accountable as I worked through old issues once again.

By then end of the day, their non-judgmental and encouraging responses further buoyed my spirits as I thought about facing the journey ahead.

Later that night, when my husband got home, I was just as painfully honest with him as I had been with my friends. He too promised his support and accountability.

I revisited the old technique that I had originally adopted five years previous in my eating disorder recovery, the one epiphany that had finally helped me find the road to freedom after almost 12 years of anorexia and bulimia: eat when hungry, stop when full.

This technique employed the habit of eating when my body told me to eat, not denying my hunger, and also not denying my full stomach once I had eaten. It is what had kept me at a healthy slender weight all through my recovery and I knew it would be what helped me gain appropriately throughout my pregnancy.

I also revisited the old “truth versus lies” technique. I wrote down all the lies that had swarmed my thinking like, “You’ll never be thin again,” and “You have no self-control because of the weight you have gained.” I replaced those lies with truths like, “After the baby is born I can lose the weight at a healthy pace and regain my original weight,” and “The weight gain is not because of a lack of self control but because of pregnancy and a body that needs extra fat to carry the baby safely.” I put this all on paper for easy reference for those times when my emotions had once again spiraled out of control, and I rehearsed it daily. I also added to it as I needed to.

I left sticky notes throughout my house, containing the truths I had recorded in my journal. They were on my mirrors, my dresser, my cupboard doors, and on books I was reading. The notes had everything from the reminder to eat when hungry and stop when full; to the truth that pregnancy was making me bigger, not lack of discipline; to prayers to God, asking for help in focusing on the precious life developing within me instead of my weight gain.

Once I was let off bed rest and put on minor restrictions, I worked out minimally as approved by my OB. I was not allowed to do heavy workouts such as four miles in one hour or accelerated pilates workouts, but she did ok daily walks at a more regulated pace and pregnancy-based, low-impact pilates.

I worked out gently, not for the purpose of losing weight or getting fit, but for the purpose of staying healthy and being prepared for labor.

In addition to eating when hungry and stopping when full, I monitored what I consumed. Although I continued to indulge my pregnancy cravings on occasion, I attempted to do what one of my best friends suggested: “Eat whatever you want, but try to find the healthy alternative first.”

One of my regular cravings was for salty foods, which, more specifically, read “Lay’s Potato Chips of any flavor.” When craving those I would reach for low fat flavored pretzels instead. If, after eating those, I still craved the potato chips, I would wait until I was truly stomach hungry again, and then allow myself the higher fat potato chips the next time I ate, eating with control and stopping as soon as I was comfortably full.

Lastly, I developed my after-birth fitness plan. Doing this gave me a sense of hope that I would be able to do something about the weight gain in a healthy way after the baby was born and kept me from feeling out of control at the weight I had to gain in the meantime.

All told, I gained a total of 58 lbs during my pregnancy. Although this was more than pregnancy journals and books recommend, my OB said based on the plan I had made for myself which included eating when hungry and stopping when full, it seemed to be what my body needed to gain to have a healthy pregnancy.

Nine months postpartum, at the writing of this article, I have lost 48 lbs, with 10 to go. The postpartum weight loss has been just as much of a journey in eating disorder recovery as the pregnancy weight gain was. I have continued to employ my recovery techniques in a way that has helped me lose the weight at a healthy and expected rate for a breast-feeding mother, and stay in control of the thought patterns that once drove unhealthy behavior. My support system and journaling have proven invaluable during this time.

I pray for a second miracle, and if I am given it, I will again be ecstatic. However, I will not be so naïve this time around and I won’t be blindsided when the old stuff rears its ugly head at me. The next time, I will be aware of the potential to be revisited by old fears and obsessions and I will be more emotionally prepared and logically ready.

And if “next time” ever happens, I will have a beautiful little girl in my sight all day long, reminding me as my body expands that the weight gain is completely worth it. This, perhaps, is the greatest eating disorder recovery technique I could possibly have during pregnancy.