Because Anorexia is characterised by an ‘intense fear of gaining weight’, people with an Anorexia diagnosis often resort to extreme measures to ensure that they avoid this from happening. This can see them severely restricting their food intake, overexercising, and/or bingeing and purging, all of which, whether it results in someone being underweight or not, can lead to serious health implications, perhaps the most daunting one being the risk of heart failure. Where the heart is a muscle, like any other muscle that is put under constant strain, without adequate rest, it will rupture. It is for this reason why the mortality rate of Anorexia Nervosa is the highest of any mental illness (one in five people with Anorexia who aren’t in treatment will die). The tragic mortality rate being because, combined with the mental turmoil that Anorexia causes, something which can, and does, lead people to commit suicide, the physical strain is also a very real danger…
** Note: Anorexia is a minefield, and it’s important to note that how one person is impacted by Anorexia isn’t necessarily how the next person will be impacted. While there are a list of common symptoms as highlighted by the DSM-5 diagnostic criteria, the list is certainly not exhaustive, and if you are struggling then you deserve to seek (and receive) help, regardless of what you weigh. **
Something which encapsulates the extent of the mental and physical turmoil Anorexia imposes on people can be seen when people with Anorexia fall pregnant.
Falling Pregnant
It is not uncommon for people who have Anorexia, or people who have a history of having had Anorexia, to struggle to fall pregnant. Often, when people are underweight they will lose their menstrual cycle, a result of their body reserving all of its energy because it doesn’t know when it will next be fed. Whilst many people who have had Anorexia in their past will recover and their menstrual cycle will return when they return to a healthy weight, for some people, the effects of Anorexia are long-lasting and, even when they have gained the weight back, they find that their menstrual cycle still doesn’t come owing to Amenorrhea.
With no menstrual cycle, this means that people struggle to get pregnant naturally. And, in cases where people do manage to fall pregnant, people with Anorexia are at an increased risk of miscarrying or, if their baby is born, their baby having health complications as a result of them having/having had Anorexia.
And, important to note; the risk doesn’t just apply to the unborn baby, but also to the Mum, both in terms of Mum’s physical and mental health.
Physical Impacts of Anorexia on Pregnancy
Physically, there is of course the increased risk of fatigue owing to low energy levels, and the heightened risk of developing infections as a result of a weaker immune system. But, perhaps most notably for Mum are the mental symptoms of pregnancy. Where Anorexia Nervosa is characterised by ‘an intense fear of gaining weight’, and in pregnancy weight gain is unavoidable, it is ultimately impossible for someone with Anorexia to get through pregnancy unphased.
Mental Impacts
As an illness which has a ‘need’ to be in control at its centre, in pregnancy, when your body will change and this is something which is as far out of your control as something could possibly be, the mental impact of this is going to be unparalleled. What’s more, things that you might’ve done pre-pregnancy to lessen the feelings of being ‘too fat’, ‘too lazy’, whatever it is that Anorexia has convinced you to be true, e.g., exercising, in pregnancy, you’re likely to lack the energy, or the physical capability, to do. And so there you are, seeing your body changing every day, but being unable to do anything about it, having to sit in your discomfort (which, in the future/ in hindsight, you might see was in fact a good thing but, in the moment, when you’re in such difficult feelings, to ‘sit in your discomfort’ feels like sitting in hell)…
Having never been pregnant myself, and with no intention of getting pregnant in the near future, I contacted Hope Virgo.
Hope Virgo, her name ‘Hope’ perfectly encompassing everything she stands for- hope for the future, hope for a society in which we are both more educated in and more compassionate towards the complexity of eating disorders, is a multi award winning mental health campaigner, author, and advocate for people with eating disorders.
Virgos work first rose to prominence in 2018 when she started an eating disorders campaign; ‘Dump The Scales’, calling on the government to review the eating disorder guidance delivered by clinicians. The campaigns goal was to ensure that everyone who needed treatment for eating disorders (/needs because, unfortunately, it is still a problem, which is why Hope continues to campaign today) could (/can) access treatment, no matter what the number on the scale reads…
‘It is time we stopped waiting for people to hit crisis point before offering them support.’
Hope, now 33 and an ‘expert by experience’, (Hope talks, writes and campaigns about eating disorders from a place of personal struggle), had her first child last year. She joins me today to tell a hopeful tale (no pun intended) of, not only the ability to get pregnant in recovery from Anorexia, but also the ability to use pregnancy as a big motivator to remain committed to recovery (see below)…
‘One of the driving factors that kept me going throughout my recovery was focusing on my motivations, telling myself that on the other side of fear there was this wonderful opportunity laying ahead of me to really live life.
While having kids wasn’t necessarily the pinnacle of all of these factors — and certainly nothing I planned to do soon — it was something that motivated me to stay well.
I needed to be OK with growing a baby inside of me, eating more and navigating pregnancy changes.’
So, this is Hope, helping me to shed some light on the under discussed, but so very essential, topic of navigating pregnancy when you’re in recovery from an eating disorder, namely Anorexia Nervosa, and, here’s what she had to say…
Hope Virgo On Pregnancy
‘On that Wednesday morning in November — as I was staring at the pregnancy test — I was excited but afraid. While pregnancy is a challenging time for many, when you throw an eating disorder into the mix, it adds a whole other complicated layer.
From navigating the foods you can and can’t eat in pregnancy — where you have to check in with yourself that you are avoiding foods for the right reasons — to sitting with emotions that you have previously numbed through eating disorder behaviours- it’s hard. The changes to your body is hard. Tiredeness stopping you from doing things is hard.
Then there are the additional risks in pregnancy, with women with anorexia tending to have smaller babies, higher chances of birth complications, and slower foetal growth.
I would be lying if I told you it had been plain sailing. There were moments when I wasn’t sure I could keep going, and moments when things felt innately tough.
For me, my pregnancy began to become like a juggling act of managing my own recovery and trying to give the best start in life to my baby- this huge pressure. As my pregnancy progressed and I got more tired, I was unable to move as much, I had to eat more, and I had to battle harder to listen to my body.
I have been very lucky to be under a consultant the whole time, and have received additional support from a dietician, and was on a pathway where I had access to extra scans because of the added risks Anorexia posed.
With this support, I knew what I had to do to stay well, I knew the importance of communication, and of focusing on my baby and its health.’
As Hope alludes, being in recovery and navigating pregnancy can be the most difficult thing to do. But, it can also provide so much joy, and a reason to keep going. Ultimately, it’s about…
1) Highlighting the unique struggle that people with a history of eating disorders might face in pregnancy, as I hope this post will go some way in doing.
&
2) Ensuring that, based on this unique struggle, people with a history of eating disorders receive adequate support throughout their pregnancy, ensuring that the mental difficulties are not overlooked.
Anorexia As A Mental Illness
When someone is visibly very unwell it can be easy to forget that Anorexia is a mental illness, the struggle they’re showing externally being only a fraction of what is going on internally. This is why it is so important that appropriate mental health support is given for people who have a history of eating disorders during pregnancy, not just for their physical health but, perhaps even more importantly, what with Anorexia being a MENTAL illness, support for their mental health, too.
With Pregnancy Comes The Opportunity To Heal
The reality of falling pregnant when you have any sort of disordered eating in your past, although an undoubtedly difficult journey, can also be a journey of so much healing. For, what greater way for us to realise that the way our bodies look is completely irrelevant to everything that our bodies can do for us/for what we have to be grateful to them for- for their ability to create LIFE- than in pregnancy…
The closing of one chapter as you slowly start to release Anorexia from your life.
The opening of another as you bring forth new life into the world.
How beautiful.
❤
Thank you to Hope for contributing to this article by sharing her experience on pregnancy in eating disorder recovery. To keep up to date with Hope’s work, you can follow her on social media-
Instagram: https://www.instagram.com/hopevirgo_/
Twitter: https://twitter.com/HopeVirgo?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor
Facebook: https://www.facebook.com/Hopevirgoauthor/?locale=en_GB
To show your support for Hope’s mission and for people living with eating disorders, sign the #dumpthescales petition here: https://www.change.org/p/eating-disorders-are-not-just-about-weight-dumpthescales
& check out her books! https://www.amazon.co.uk/Hope-Virgo/e/B01NBIRW4V%3Fref=dbs_a_mng_rwt_scns_share
For more information/advice/support on eating disorders, I’d encourage you to take a look at ‘Beat eating disorders’: https://www.beateatingdisorders.org.uk/ (UK based), and/or NEDA: https://www.nationaleatingdisorders.org/ (US based).
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