Why Is Pregnancy the Eating Disorder Trigger No One Talks About?

When I started trying to get pregnant, five years ago at age 32, I felt ready to be a mom. After a decade in therapy, I was sure my experiences with disordered eating were behind me. My own childhood had been traumatic, but I was excited to move into this next chapter feeling strong. With luck, I hoped, my child wouldn’t have to go through anything like what I did at age 11, when, because of my scoliosis, I was trapped in a back brace 23 hours a day, seven days a week for more than two years.

My first middle-grade novel, Braced, was all about that, and it was about to be published. I’d signed a contract for two more books, on self-worth and body image, from which I drew on my years of disordered eating — restricting, binging, obsessively dieting and over-exercising — that had taken over my life after my brace came off. I was proud of how far I had come. I thought I was mentally and emotionally prepared for how my body would inevitably change during pregnancy.

I had no clue how wrong I was.

Overcoming disordered eating

Let me back up a minute: Like so many women, I spent my teens and 20s preoccupied with what I thought I could and couldn’t eat. I tracked and calculated and thought incessantly about how hard I worked out, how I felt in my body and the number that appeared on my scale. If I ate and exercised “right,” I had a good day and thought myself deserving of love and compassion. If I didn’t, it was a bad day, and it was my fault. And every time I binged on food (after which I inevitably restricted my food) I told myself just how worthless I thought I was on repeat. I felt that my value as a person and how I ate were one and the same.

But over a few years, with lots of practice, I’d come around to living in a way that reflected a new way of thinking: I had come to truly care about myself. I’d tossed my scale. I’d stopped running, because it hurt my back and triggered my yo-yo dieting. And I stopped counting and tracking what I ate.

Instead, I followed the principles of intuitive eating, and didn’t think of foods as “bad” or “good” anymore. I knew I was worthy, no matter what I ate or how much (or little) I exercised. I was also consciously avoiding diet culture traps, which is pretty hard, since we live in a society that values a person’s shape and size over their health and well-being. I was doing well.

And then I saw the positive result on my home pregnancy test, and I was so grateful. I couldn’t wait to tell my doctor.

“Make sure the prenatal vitamins you’re taking have B12 in them,” she said, first thing. And then, “You should also make sure to avoid alcohol, raw foods, high mercury fish, unpasteurized cheese and deli meats. Reduce your caffeine to no more than 200 milligrams per day.” I wrote everything down, but an uncomfortable feeling came over me.

She went on: “You don’t need to eat for two, but you should eat at least an extra banana a day. And keep exercising — that’s good for the baby. Just make sure your heart rate stays under 140.”

I hung up the phone. My pregnancy had just begun and I was already feeling overwhelmed and like there was so much potential for failure.

Eat this, not that

That’s because a key to my recovery from disordered eating was finally freeing myself from diet culture “rules,” which in my most difficult years took me away from focusing on what my body was telling me it needed and kept me obsessed with food and exercise.

Now here I was, looking at a list of things I couldn’t eat or do, and another list of things I had to start eating and doing. I wanted, of course, to give my growing baby what it needed to be healthy, but all those dos and don’ts and numbers and calories made my head spin.

Soon I started to feel pretty awful, physically. Like many pregnant women, I felt exhausted, nauseous and sick, almost immediately. It took me right back to puberty, when my hormones were high, everything was changing and I felt out of control — and a time when I’d started restricting my food to cope. It wasn’t long before I realized: Pregnancy is actually a lot like puberty. You feel vulnerable because you’re going through a big transition where your body and your life change drastically over a short period.

It didn’t help that I’d gone off my ADHD medication, because at the time I was told it wasn’t safe to take during pregnancy. This added stressor made regulating my attention and emotions very challenging. The allotted milliliters of coffee my doctor had said were safe to drink felt like a life raft, helping me get through each day. But because pregnant people are supposed to avoid caffeine generally — and I knew many who had completely given it up — even with the doctor’s approval, I felt like I was doing something illicit.

And so, because I knew I needed that coffee to function, I was hyper-focused on following every other rule (hyper-focus is a symptom of ADHD). Without the support of my meds, I struggled to get my mind unstuck and transition away from the rabbit hole of Googling to make sure I was doing everything right in my pregnancy.

During those early weeks, I was so tired, I would come home from work and fall asleep for the night immediately. I didn’t have energy to exercise, but my doctors said that exercise was important for the health of my baby. So I’d wake up early and go to spin class anyway — even though my body was craving rest. When you’re recovering from disordered eating, getting back in touch with what kind of exercise and how much is healthy for you and for your body is so important. But in my insecurity and anxiety, I overruled myself. I told myself that listening to the doctor’s advice about exercise — over what my body was telling me I needed — was key to being a great mother.

And of course, my body felt totally out of my control, because in a way, it was. It was growing and nourishing another entire human. But it stressed me out. Overnight, none of my clothes fit. I was constantly worried about gaining too much weight, and at the exact same time, not gaining enough. I had fought so hard to stop measuring my success or failure based on a number, and now, I was being forced to weigh in at every doctor’s visit. Despite multiple conversations with nurses and doctors about opting out of the weigh-in, I was told that monitoring my weight was important for the health of my baby. It felt like my success as a mother hung in the balance every time I stepped on the scale.

Am I pregnant-ing wrong?

The worst part was that no matter what the scale said, I was left feeling like I’d failed. If I had gained weight, I was scared it would keep going up until it was more than the doctor’s recommendation. If I hadn’t gained enough weight, I was failing at my new responsibility. It was the very first step of caring for a child and I was already bad at it.

So I tried closing my eyes on the scale and opting out of hearing the number, thinking that might make it easier to manage my emotions. Nope. I then felt totally adrift with how I was doing as a vessel for my baby. Not knowing felt worse. I felt trapped and uncomfortable inside myself.

After awhile, I had to talk about it. When I started to open up about how I really felt, I was shocked by the response I almost universally received. Everywhere I turned, friends, other expectant moms, and my doctors, whether they meant to or not, dismissed my pain.

“You think it’s hard now. Wait until the baby comes.”

“The baby is healthy. Be grateful.”

“I loved being pregnant. You should enjoy it.”

“Isn’t this just the happiest time in your life?”

“You shouldn’t complain. You’re not even in the third trimester!”

I felt so much more alone, like I was pregnant-ing wrong. Was I the only one feeling this way? What was wrong with me? Why couldn’t people understand what I was going through? It was exactly how I felt in my back brace, not being able to dance or buy the clothes I wanted to wear or bend over to put my shoes on, and feeling so isolated. It seemed like I was reliving my adolescent trauma all over again.

Back when I was twelve and in my scoliosis brace, whenever I tried to speak up for myself or ask for help, I was told that I was lucky because other people had it worse and that I should be grateful for all I could do and that my parents could afford to get me help. I was surrounded by well-meaning people who didn’t want to focus on my pain. They believed that telling me everything was okay would make it that way, instead of creating space for my feelings to be legitimate and my pain to be real. All I felt was shame for having such a hard time.

Twenty years later as a pregnant woman, I again was consumed by how my body was changing and by how uncomfortable and misunderstood I felt. And ashamed of feeling that way — I was lucky to be pregnant, wasn’t I?

Finding my person

And sure enough, a couple of months into my pregnancy, I started to slip back into old habits, spiraling toward a disordered eating relapse. I started restricting, overthinking, binging and shame spiraling. I even dug out my scale. It felt very familiar — and scary.

Thankfully, I recognized what was happening almost immediately and got professional help through my therapist. In the midst of my pain and loneliness, I wrote down everything I was feeling and experiencing. These raw moments became the start of my latest novel about disordered eating, Taking Up Space. Since I started therapy in my early twenties, writing has been a tool I’ve used to validate myself when I’m struggling to believe that I matter and that I deserve compassion. I spent the rest of my pregnancy working hard to shut down my negative self-talk, and once again disconnect what I ate and how I felt in my body from how I valued myself.

And guess what? I wasn’t the only one who was having a stressful pregnancy. During my third trimester, I met a woman whose due date was almost the same as mine. Within minutes of meeting, she shared that she was in recovery for an eating disorder and, like me, had been having a hard time. We talked for hours that day, and for all the days that followed, until we gave birth a few days apart.

We made space for each other to hate being pregnant — and still be excited to meet our baby girls and anxious to be first-time moms and unsure about what gadgets we really needed to buy and confused about breastfeeding.

I don’t know how I would have managed during those challenging weeks without the support of my new friend, who offered me exactly what I needed: solidarity, validation, empathy and, most importantly, permission to be both upset and happy at the same time.

There is such a strong a mythology around pregnancy. We’re bombarded with messages and marketing that if you’re pregnant, you’re supposed to feel only joy. It’s as if we’re afraid that if we tell the truth, even to ourselves, that women might not want to have babies. Instead of allowing for the life-altering experience of growing a human, while also managing the ups and downs of regular life, we perpetuate the trope of pure bliss that creates shame and silence for those of us — many of us — who have a hard time during pregnancy. And that shame discourages women from seeking support from their loved ones or professional help from a clinician.

That’s why, even as an adult, I love to write for middle school kids. That time of life is pretty much a universal suckfest. It certainly was for me. But kids, and adults as well, need to know that whatever they’re going through, it’s okay to struggle and, despite what society tells us, there isn’t one right way to experience anything in life. It may sometimes feel that way, but you are not alone in your pain.

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