“We tend to associate therapy with having a really big problem,” Braverman says. “But if you’re struggling with body image, it may only take a few sessions to find out where these negative messages are coming from.” Once identified, they’re more easily handled—especially with a therapist’s help. Your obstetrician or midwife will most likely be able to recommend a therapist.
Certainly, if you’re feeling great about your pregnant body, enjoy these nine months. If you see yourself as less than stunning, however, keep in mind that even if each day seems to drag, pregnancy does have a 40-week (or so) deadline. If you focus on nutrition rather than dieting, the result—a healthy baby—will be even more enviable than thin thighs.
Pregnancy and eating disorders
Research shows that many women with eating disorders stop their destructive behavior during pregnancy—some quite easily. However, “women with a history of anorexia, bulimia, compulsive exercise or other eating disorders should recognize that pregnancy can be a tremendous stressor, bringing up anxiety issues around food and the body,” notes Margo Maine, Ph.D., author of The Body Myth: Adult Women and the Pressure to Be Perfect. The good news? You can overcome such hurdles.
Share your history
Be honest with your care provider so that she can monitor your weight gain more carefully. Some doctors will offer early ultrasounds so you can see the living results of your healthy eating.
Prepare for rapid gains
Women with a history of restrictive eating may gain weight quickly at the beginning of their pregnancy. “This is normal,” Maine says. “Your metabolic rate will be lower, and since the body knows it needs to gain weight, it will do so sooner.” Then your weight gain should slow down.
“Like other psychiatric illnesses, eating disorders often have depression, anxiety or self-esteem problems underneath,” says psychotherapist Marianne Tebbens, M.S., L.P.C. If you find your disorder lingers, a therapist can help you work on these root causes.
If you can’t control your eating disorder, don’t go it alone. “It’s critical to get help from professionals with experience in treating eating disorders, including a registered dietitian who can ensure that your food intake is sufficient to support a viable pregnancy,” Maine advises. Ask your medical provider to recommend a specialist who can assess the level of care you need, whether it’s outpatient services or hospitalization. Maine suggests the National Eating Disorders Association and www.bulimia.com as additional resources for referrals and books.