Navigating ED Recovery in Fertility & Pregnancy

Navigating an eating disorder in fertility and pregnancy is a uniquely difficult journey for so many reasons. Every client I’ve worked with has had a completely different experience with eating disorder recovery while trying to conceive or pregnant.

Disordered Eating & Fertility

Disordered eating can greatly impact fertility. Many people, especially those with hypothalamic amenorrhea, are referred to fertility clinics without ever working on recovery and nutritional rehabilitation. I see this especially with my clients who are not in the “underweight” BMI category, and especially if they live in larger bodies. Fatphobia absolutely plays a role in who gets referred to a dietitian for help with an eating disorder, and who gets told to try dieting, therefore worsening their disordered eating. I also see this often in my clients who may have received eating disorder treatment in the past, but are still stuck in a cycle of restriction and overexercise despite being less extreme with their behaviors than they used to be. Often, full recovery can completely solve fertility issues, but regardless is very important to help with the success of any fertility treatments. Reaching out for support with a dietitian before starting fertility treatments can potentially save you tens of thousands of dollars.

Disordered Eating & Pregnancy

In pregnancy, many people report higher levels of body acceptance, and higher motivation to work on their recovery. This is awesome!! I love helping my clients move with that momentum to create lasting change for themselves and their families. It’s really important to continue working on recovery in pregnancy, as there are increased risks for untreated eating disorders including:

• Small for gestational age or intrauterine growth restriction

• Large for gestational age

• Gestational diabetes

• Iron-deficiency anemia, possible other micronutrient deficiencies

• Spontaneous abortion and preterm delivery

• Microcephaly and other birth defects

I also want to acknowledge that many people with an eating disorder are not pregnant by their own choice. The rates of unplanned pregnancies among people with eating disorders are higher than the general population, partly due to the fact that some folks may have an irregular or missing period as a symptom of malnutrition, and therefore be unable to identify their fertile window and plan intercourse accordingly. Others might even think that they are completely unable to get pregnant, and therefore not take the appropriate measures to prevent pregnancy at all. If you are currently experiencing an unplanned pregnancy, I want you to know that you are seen. Sharing your thoughts and feelings about being pregnant with your therapist and dietitian is important so that we can support YOU and help you care for your body.

Disordered Eating in Postpartum

One of the most important reasons to seek support for disordered eating in pregnancy is to help prepare for postpartum. Rates of eating disorders in postpartum are almost double the rates of eating disorders in the general population. Not only are folks struggling with the transition to parenthood, but isolation and the societal pressure to “get their body back” can put new parents in a vulnerable position. Working with a dietitian in preconception and pregnancy can help with building nutrient stores, learning coping skills, and improving body image. This all can help greatly in preventing relapse in postpartum.

Bigger than this, I’m personally passionate about supporting folks in recovery on their fertility/pregnancy journeys because of the lasting change it can create for themselves and future generations. Creating a healthy relationship with food and body for yourself is the first building block in creating an environment to encourage healthy body image for your children. Not only do you deserve the mental and physical benefits of full recovery, but your children do too. Recovery is so worth it.

For folks with an active eating disorder, I provide 1:1 nutrition coaching across the US! Click here to read more about what that looks like and apply to work with me.

Feeling pretty solid in your recovery and looking for a safe space to explore evidence based, body positive fertility and pregnancy nutrition? I created Fully Nourished Pregnancy EXACTLY for this purpose! Fully Nourished Pregnancy is an online course and community designed to walk you step by step through flexible, non-restrictive eating to nourish your body in fertility and pregnancy. Click here to read more about this amazing program and enroll today.