Does This Baby Make Me Look Fat?
Chief Medical Officer and Medical Director of Child and Adolescent Services, MD weighs in on disordered eating and body hate during pregnancy.
Kathy is 17 weeks pregnant, and it's making her want to vomit.
It isn't morning sickness triggering her impulse: It is bulimia. And each time she sees her swelling belly in the mirror, feels her clothes growing tighter or thumbs through a magazine and spots yet another pregnant celebrity with a marble-sized baby bump, she wants to throw up again.
Before her pregnancy, Kathy (who asked SELF not to publish her last name) thought she had recovered. Her eating disorder had begun in college, and for seven years, it ruled her life. A voice louder than her own good sense and judgment told her, You aren't worthy of food. You are disgusting. "Purging calmed my mind," she admits. "I didn't feel anything for 5 or 10 minutes afterward, and that was alluring when my mind was spinning out of control."
She stuck her finger down her throat after every breakfast, lunch and dinner—up to 12 times in a day. She exercised relentlessly to burn off what she did eat. Yet nothing changed. "I felt like a total failure for having an eating disorder but not being able to lose weight," she says. Depression set in—and anxiety. She couldn't sleep. Her stomach hurt from all the heaving. She hid her problem from her friends and family, drawing herself ever more inward.
During graduate school for social work, Kathy's obsession with food and weight left little room for studying. "It was taking up 150 percent of my mental capacity," she says. "I thought my eating disorder was going to kill me. I didn't want to leave my house, but I did so that people wouldn't know something was wrong."
Finally, she got outpatient eating disorder treatment at Park Nicollet Melrose Institute in St. Louis Park, Minnesota. Even that step made Kathy feel, perversely, like a failure. "I figured if I were skinny enough, they would have hospitalized me. But they didn't, so I felt that I couldn't even be good at having an eating disorder," she says.
Through intensive therapy and nutritional counseling, Kathy slowly got better. She stopped bingeing and purging, even though she still wanted to. Soon she met the man who would become her husband. Getting married made her feel like a normal, healthy person for the first time in her life. Deciding to get pregnant was another story entirely. "I knew I'd be weighed a lot and that I was going to get bigger, a lot bigger," she says. "I wanted a baby so bad—but the eating disorder side of me really did not want that to happen."
When she got pregnant, Kathy had been in treatment for three years and hadn't purged for two. But at 17 weeks, she feels her hard-won recovery is threatened. "Anytime I eat, my disorder tells me, It's too much; you are going to gain weight; you are out of control," she says. She has to choke down even healthy food, like the bagel with peanut butter she eats for breakfast. "To that, my eating disorder voice says, That's too many calories, too many carbs. It will make you gain weight," she says.
She tries to imagine her growing baby depending on her, even judging her. "I don't throw up because the baby would know," she says. "Everything I do is influencing that baby, and I want it to be healthy. [But] the way my body is changing terrifies me."
Would having a baby make you appreciate your body—or hate it? It's a question many women ponder long before they ever take a pregnancy test. When women do conceive, many—both disordered and nondisordered eaters alike—are motivated to eat more healthfully. But others struggle. "Some women with a history of severe eating disorders, although they are a small minority, become so unhappy with what their pregnancy is doing to their body that they intentionally try to sabotage it, beating on their stomach with their fists," says Ovidio Bermudez, M.D., chief medical officer and medical director of child and adolescent services at the Eating Recovery Center in Denver. "That's how overwhelming their feelings can be."