Body image and eating disorders

Adjusting to a changing body in pregnancy

It is common for women to struggle with physical changes such as stretch marks, changed body shape, weight-gain, surgery scars and weakened pelvic-floor.  Women may perceive themselves as overweight or unhealthy after giving birth and set strict goals or timelines to lose “baby weight”. They may experience pressure from themselves, from people close to them, or from social media. Understanding how women's bodies adapt and recover after birth is important in establishing realistic expectations for women and their partners.

The Challenges of a changing body during pregnancy and the postpartum period

The experience of and emotional response to the rapid changes in body shape and size during pregnancy and postnatally vary from person to person. While some women enjoy the physical aspect of being pregnant, others experience significant discomfort or body image dissatisfaction, and do not find pregnancy enjoyable at all.

Physical changes such as weight gain, fluid retention, larger breasts, varicose veins and stretch marks can often trigger negative thoughts and feelings about a woman's appearance. These negative feelings may be exacerbated by hormonal fluctuations and tiredness both before and after having a baby. There can also be some physical changes after birth which may have longer lasting effects on both physical and emotional wellbeing. Seeing a physiotherapist who specialises in pregnancy and postnatal care can be helpful at this time.

Body image dissatisfaction in pregnancy can increase a woman's risk of developing an eating disorder during or after pregnancy. The factors that contribute to disordered eating are complex and can impact individuals regardless of background or culture. Support from family, friends and health professionals can help women understand and manage body image and eating disorders.

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Body image and eating disorders

In this vulnerable time and with cultural and social pressures, it is understandable that many new parents struggle with how they perceive their body image. Body image refers to how a person perceives their own body, their own attitude to it and what psychological effect these perceptions and attitudes have on their wellbeing. Nurturing and growing a baby and giving birth represents a strong, powerful body; however, in some cultures, an emphasis on being thin can undermine concepts of strength and resilience.

Negative body image can impact self-confidence and emotional and mental wellbeing. Women who have experienced a previous history of body image issues or disordered eating may find their symptoms are exacerbated or re-emerge in the perinatal period.

Disordered eating, which can include restrictive eating, binge eating or excessive exercising, can be a serious health issue that needs treatment and support. Parents who engage in problematic eating behaviours after birth should seek support from their GP, or other trusted health professional. It is important to know that these struggles can be managed with the help of an experienced health professional and specialist organisations such as the Butterfly Foundation.

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Body dysmorphia

Body Dysmorphia can affect postpartum women, and is the term given to anyone who is experiencing these symptoms:

• Extremely preoccupied with a perceived flaw in appearance that to others can't be seen or appears minor
• A strong belief that they have a defect in their appearance that makes them ugly or deformed
• A belief that others notice their appearance in a negative way or mock them  
• Constantly fixing or hiding a perceived flaw, such as frequently checking the mirror, grooming or skin picking
• Frequently seeking reassurance about their appearance from others

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Seeking help and support

Those with a current, diagnosed eating disorder should seek medical advice before getting pregnant. GP’s can provide initial advice and appropriate referral to ensure optimum care. With appropriate support it is possible to recover, and transition to a healthy pregnancy. If there are concerns around eating and body image issues emerging for the first-time during pregnancy, seeking early support from a pregnancy care professional is also recommended.  

Avoiding unhealthy media and online spaces that present unrealistic images of pregnancy, parenthood, and the postpartum body is important. Instead, focus on the amazing work the body is doing to help a baby grow and develop.

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Other helpful resources

Butterfly Foundation ‍

National Eating Disorders Association‍

The Royal Women’s Hospital ‍

National Eating Disorders Association ‍

Jean Hailes for Women’s Health