The Center for Eating Disorders is honored to be able to feature Claire Mysko and Magali Amadei as guest bloggers in our Nuture series for moms and mothers-to-be.   Their book, Does This Pregnancy Make Me Look Fat? The Essential Guide to Loving Your Body Before and After Baby, offers a refreshingly realistic and healthy perspective on body image during pregnancy. Recently, we asked Claire and Magali to offer their best advice to women, especially those who have struggled with eating disorders or disordered eating, on how to navigate the adventures of pregnancy without over-focusing on weight and size.

This is what they had to say…

Pregnancy is a time of great anticipation. It’s also a time that is measured meticulously from start to finish—in weeks on the calendar, milestones on the sonograms, and numbers on the scale. And for those with histories of disordered eating, all that counting can be dangerous territory. Here are five tips to help every expectant mother get beyond the numbers game.

 Tip # 1:

Take weight out of the equation. This might seem like a radical suggestion considering that pregnancy weight gain and post-baby weight loss are such hot topics of conversation among mothers-to-be and new moms. To add fuel to the fire, weigh-ins are often the center of every visit to the doctor. But truthfully, there really isn’t any reason you need to keep track of your weight. If you know that it could become an unhealthy fixation, tell your OB or midwife that you prefer not to discuss the number unless it becomes a medical issue. Step on the scale backwards and remind the physician’s assistant that you don’t want to be told your weight. Then enjoy the looks on people’s faces when they ask you how much you’ve gained and you respond, “I don’t know.” As a bonus, you’ll soon discover that there are plenty of other interesting—and more substantive–things about becoming a mother that you can talk about.

Tip # 2:

Choose a health care provider who is sensitive to food, weight and body image issues. Women who have struggled with poor body image and/or disordered eating need to find prenatal healthcare providers who are knowledgeable and compassionate when it comes to these issues. We’ve heard from many women who ended up in the examination room—and sometimes even the delivery room—feeling belittled and unsupported by their own doctors. The best way to avoid this scenario is to push through whatever shame you might be feeling and be upfront with your OB or midwife about your history and your pregnancy-related body image fears. If you’re met with criticism or any other reaction that makes you feel uncomfortable, remember that you are well within your rights to walk out that door and find another doctor who will treat you with more respect. Of those we surveyed, 73% of pregnant women with body image issues and histories of eating disorders and disordered eating said they had not discussed this history with their OBs or midwives. It’s time to break that dangerous silence.  

Tip #3:

Clean out your closet. One of the kindest things you can do for yourself is to pack up anything in your wardrobe that would qualify as “form-fitting” as soon as you see that plus sign on the pregnancy test. You will start gaining weight before you start showing, so this is a surefire way to avoid the agony of trying to squeeze into something that’s too small. And we’re not kidding about packing it up. Put those clothes in a box, and seal it up tight. Personally, we advise you not to open it again until a year after you’ve given birth. You know what they say about nine months to gain the weight, nine months to take it off? Well, we’re adding a few extra months for good measure. That’s a lot of seasons in fashion-speak, so chances are good that you won’t even be interested in some of those clothes once you dig that box out again. For sanity’s sake, pregnancy is a time when you must let go of your attachment to a specific clothing size. As someone who is about to become a mother, your sense of self-worth cannot hinge on whether you can fit into whatever size you think is “ideal” for you. Is that a belief you would want your child to absorb? What’s really ideal is to find clothes that are flattering, comfortable, and versatile. Sizes vary from store to store, so don’t have a heart attack if you end up wearing sizes that seem beyond what you imagined you would wear. That goes for pregnancy and it applies for after delivery, too. The number on the scale doesn’t define any of us, and neither does the number on the tags of our clothes. If it’s making you that miserable, take a pair of scissors and cut those labels out of sight and out of mind.

Tip #4

Be aware of the triggers of pregnancy. The incessant counting, comparing, and measuring that happens during those nine months and beyond can tap into some of the very vulnerabilities that are linked to eating disorders and food and weight obsessions. Perfectionism, loss of control, feelings of isolation, and memories of childhood often bubble right to the surface. But if you’re getting the support you need, you’ll have a better chance of weathering those storms without resorting to self-destructive habits. Resist the urge to shut down or close off.  Remember that there is nothing shameful about asking for help. It’s the most courageous thing you can do for yourself and your baby. Look at your recovery as an ongoing process that will help you reach your full potential as an individual and as a mother.

Tip #5

Break the cycle of body hatred. Allow yourself to celebrate the fact that your body is working some serious magic right now. Before you get stymied by stretch marks or focused on flabby skin, take time to reflect on how you will teach your child—in your words and in your actions—that you appreciate your body because it brought them into the world. We have the power to help future generations grow up placing a higher value on good health than on weight and physical appearance. But before we can pass along those positive attitudes, we must first embrace them for ourselves.

Make your commitment now by signing the  Healthy Beauty Pledge for Mothers and Mothers-to-Be.

Visit Claire Mysko’s website  for more empowering and encouraging blogs about body image.

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Adapted from Does This Pregnancy Make Me Look Fat? The Essential Guide to Loving Your Body Before and After Baby by Claire Mysko and Magali Amadei

Over the course of the next few months the Nurture blog series  will explore the central theme of motherhood involving various topics such as fertility, pregnancy, childbirth and parenthood as they relate to body image, and overall wellness.  Several of these topics, in addition to being potentially sensitive subject matter, also have a language all their own.  As we approached these blogs, we thought it was important to make sure that everybody is speaking the same language – hence, the glossary page. 

Many of the terms used in this blog series get tossed around a lot in our society with the assumption that everyone knows what they mean, but that isn’t always the case as we will point out in future blogs entries regarding the term “body image”.  We also wanted to provide clarification for terms that are sometimes used in two different ways (i.e. “going on a diet” vs. “a balanced diet”).  Additional terms, like “low birth weight” or “amenorrhea” are more technical and so we thought it couldn’t hurt to provide a little refresher for these more medically-based terms as well. Throughout this series of blogs the glossary will grow and terms will be added, feel free to use it as a reference when reading specific blog entries and refer back to it as often as needed.  If you have any questions or suggestions for terms that should be added let us know!

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Nurture. GLOSSARY

Amenorrhea: Amenorrhea is the absence of menstrual bleeding. Primary amenorrhea is the absence of menstrual bleeding and secondary sexual characteristics (for example, breast development and pubic hair) in a girl by age 14 years or the absence of menstrual bleeding with normal development of secondary sexual characteristics in a girl by age 16 years. Secondary Amenorrhea is the absence of menstrual bleeding in a woman who had been menstruating normally but later stops menstruating for 3 or more months and its occurrence is not a result of pregnancy, lactation, systemic hormonal birth control pills, or menopause. (source: emedicinehealth.com) Amenorrhea can be a symptom of disordered eating, over exercise or an eating disorder.

 Body Image: Body image is… how you see yourself, how you feel about your body and shape, and what you believe about your body.  Body image is made up of memories and assumptions about your body and the feelings you have when you think about or visualize your own body. Body image is also how you feel in your body as you move and control it.  Body image is not dependent on how much you weigh, how tall you are, or your personal style.  A person’s body image can exist anywhere on a continuum – from a very positive and healthy body image to a very poor or negative body image.   

Diet (noun): The customary amount and kind of food and drink taken by a person from day to day; i.e. a balanced diet:  one containing foods which furnish all the nutritive factors in proper proportion for adequate nutrition. (Dorland’s Medical Dictionary for Health Consumers. © 2007 by Saunders, an imprint of Elsevier, Inc. All rights reserved.)

Diet (verb): A Reduction of caloric intake or manipulation of food and drink with the intent to lose weight.

Disordered Eating: A significant deviation from normalized eating patterns that may include dieting, fasting, bingeing, or skipping meals. Disordered eating disregards internal regulation of hunger and fullness and provides the body with much more or much less than the body needs to function properly.  Instead of feeling good after a meal, someone who has disordered eating will often experience feelings of guilt, shame, discomfort, fear or discontent.

Infertility:  The inability to become pregnant after persistent attempts over a given period of time, usually determined to be one year in humans. 

Low Birth Weight: Babies born weighing less than 5 pounds, 8 ounces (2,500 grams) are considered low birth weight. Low birth weight babies are at increased risk for serious health problems as newborns, lasting disabilities and even death. About 1 in every 12 babies in the United States is born with low birth weight. (March of Dimes Foundation)

Normal Eating: Eating in response to the body’s natural hunger and fullness cues, with a variety of food choices that offer balance, diverse foods and moderation.  Normal eating generally involves eating three regular meals per day and 1-2 additional snacks in response to hunger. Normal eating involves nourishing the body for the purpose of providing energy and maintaining well-being and should result in feeling good afterwards.

Over Exercise / Excessive Exercise: 1. Repeatedly exercising beyond the requirements for good health; when an individual engages in strenuous physical activity to the point that is unsafe and unhealthy. 2. The Diagnostic Manual, the DSM-IV-TR, defines excessive exercise as exercise that “significantly interferes with important activities, occurs at inappropriate times or in inappropriate settings, or when the individual continues to exercise despite injury or other medical complications.”  3. Some of the physical dangers that may become an issue for someone exercising too much can be: dehydration, stress fracture and osteoporosis, degenerative arthritis, amenorrhea, reproductive problems, and heart problems.

Set-Point / Set-Point Theory: 1. Set point is the weight range in which your body is programmed to weigh and will fight to maintain that weight. Set point is often referred to as an internal “thermostat” that regulates weight. 2. According to the set-point theory, there is a control system built into every person dictating how much body fat he or she needs to maintain homeostasis. Some individuals are genetically programmed to have a high setting, others have a low one. According to this theory, body fat percentage and body weight are matters of internal controls that are set differently in different people. 3. The set point theory suggests that despite dieting efforts, the body eventually tends to return to its set point weight or will adjust metabolism and other mechanisms in an attempt to do so.