Navigating Postpartum Body Image and the Risk of Eating Disorders
6 minutes
Research supports a belief that most, if not all women would likely agree with: the majority of birthing moms—at least in Western countries—experience some negative thoughts or feelings about their postpartum bodies. Even if a woman felt confident about her body during pregnancy, because, after all, there is no need to suck in that gut for many freeing months, once the baby is born, the aftermath can be jarring. A woman’s body doesn’t simply revert to its pre-pregnancy state, nor is it meant to, despite many celebrities leaving the hospital dolled up and curiously lacking any proof they were pregnant. You might be thinking, "Yeah, I feel more disproportioned, have new layers of skin, fat, stretch marks, dark patches, and a loss of firmness." Processing these changes while caring for a newborn, dealing with fatigue, potentially nursing, and trying to figure out what your life has just become can leave you feeling vulnerable, uncomfortable, and simply annoyed at yourself, society, and everything that reminds you of how you look. Damn that mirror!
For many women, these thoughts are fleeting. Many moms can truly appreciate what their body has done and set aside those pesky thoughts about body image ideals. They may be able to prioritize other concerns or reframe their feelings; they likely also always appreciated their body or never succumbed to pressure to conform their body to some ideal. Anecdotally, I don’t see many of these unicorns, but I’m sure they exist.
However, for the majority of women who haven’t easily pushed past the bombardment of social media comparisons, fad diets, and seeing their mothers constantly complain about their bodies, it can be a real source of frustration. Furthermore, for those with a history of heightened body image dissatisfaction or an eating disorder, these postpartum changes can be extremely persistent, impacting daily functioning, how they dress, their nutritional habits, exercise routines, and how they show up for themselves and others. It can become an intense source of rumination and lead to a full-blown relapse or a new eating disorder that takes years to recover from. If this sounds like you or someone you know, it’s crucial to address these issues early on, because the longer disordered eating persists, the harder it becomes to overcome. One day you may look back (or perhaps you already are) and realize that your parenting journey was marked by body dissatisfaction, yo-yo dieting, depression, low self-esteem, avoidance of anything related to summer, and less clothing (e.g., no interest in pool or beach days), and a lack of enjoyment in life—primarily because you hated your body.
The difference between uncomfortable passing thoughts and steps toward a more disordered path can be subtle, especially in the midst of caring for a new baby, where making excuses for missed meals or secretly eating out of shame can easily be brushed aside. A therapist well-versed in body image and disordered eating can often spot warning signs before an individual is ready to admit there is a problem. Unfortunately, however, mothers typically enter therapy once they are already deep into an eating disorder. I have had clients come to me primarily for postpartum anxiety or depression, and as they work through their emotions and define their identity as a new mother, I may notice destructive coping mechanisms like food restriction, over-exercising, or neglecting nutrition and self-care. These clients tend to fare much better than those who come in after recognizing very destructive eating habits that have persisted long before reaching out to me. And I get it—moms are busy and often have the mentality that their own issues come last. Many also believe they can address these issues later when there is ‘more time.’ To which I say, good luck with that. That may happen in eighteen years. The two biggest risk factors for developing a long-term eating disorder are persistent restriction (even if not undernourished but still rigid around food choices) and not receiving early intervention.
Understanding Postpartum Body Changes
After childbirth, a woman's body undergoes several common physical changes as it recovers from pregnancy and delivery. Many women find that they retain some of the weight gained during pregnancy. Additionally, the rapid expansion and contraction of the skin during and after pregnancy can lead to stretch marks, which are common and natural but are typically viewed as unpleasant due to societal standards ingrained in us. Think about all the advertisements you encountered during your pregnancy about preventing stretch marks—or maybe you even googled it, which is why they’re showing up in your ads. The truth is none of those remedies work. Your body is either prone to stretch marks, and they will happen, or it isn’t, and they won’t.
Additionally, pregnancy can lead to a loss of muscle tone or undiagnosed diastasis recti (where the abdominal wall splits to accommodate the baby) that doesn’t resolve itself naturally—this can be repaired, by the way. And, of course, let’s not forget the breasts. There is a whole array of terms I’ve heard regarding breast changes, such as flat, droopy, lopsided, discolored, veiny, saggy, and deflated, to name a few. Hair loss, larger feet, varicose veins—the list goes on and on. The focus tends to be on the negative, the dislikes, and the yearning for something ‘more desirable.’
Although these physical changes are a natural part of the postpartum recovery process and, in a utopian world, would be celebrated and considered beautiful, our ‘bounce-back culture’ creates pressure to return to pre-pregnancy weight and appearance—or even achieve a more ideal body than before. New mothers often compare everything: birth experiences, milestones, nursing practices, the amount of childcare help they utilize or don’t, and so on, with postpartum body and exercise habits often leading the way. The rise of social media over the last decade has taken this comparison to exponential levels, making it almost impossible to escape watching someone else ‘mothering better.’
Recognizing Negative Thought Patterns
Recognizing negative thought patterns is crucial for new mothers as they navigate the postpartum period. For example, you might think, "I will never get my old body back," "I should be able to lose this weight faster," or "I can skip lunch; I have too much to do anyway, and my little one needs me right now." These thoughts can be pervasive but may not be fully acknowledged as needing attention. However, by not taking a moment to recognize how these thoughts might impact your overall emotional well-being, you risk shaping your postpartum motherhood experience to be fraught with disappointment, body shame, and disordered eating habits that could follow you for years to come. Partners and family members should also pay attention to how often their loved one engages in self-critical thoughts or statements. If they notice an increase in negative self-talk, avoidance of mirrors, a new reluctance to undress in front of their partner, or new behaviors related to diet and exercise, it's a cue to seek support and learn how to help someone struggling with an eating disorder.
The Impact of Previous Body Image Issues
One of the biggest risk factors for someone struggling with their body or disordered eating after pregnancy is a history of body image issues or unresolved issues around food and exercise. These may have felt manageable for years, but there was always a bit of underlying angst. The intense physical and emotional changes that childbirth entails can act as a trigger, leading to a resurgence of an eating disorder, even if it looks different from what it previously was. For instance, I had a client who experienced several phases in her life where she met the diagnosis of anorexia. She managed her pregnancy without reverting to old habits; however, the postpartum period led to binge eating, where she constantly felt out of control, which coincided with depression. There was no single reason we could pinpoint for what was occurring, but we identified increased hunger due to breastfeeding as one trigger. The ravenous feeling she experienced after birth scared her, leading to restriction, which then escalated to out-of-control eating when she was tired, vulnerable, emotional, and had little bandwidth left to rely on her usual “willpower” as she described it. Another client, who was previously diagnosed with binge eating disorder, developed a mix of orthorexia (a rigidity around very clean/healthy eating) and bulimia after becoming a mother. This illustrates how vulnerable the postpartum period can be, requiring heightened awareness of how one perceives their body and nourishes oneself.
Warning Signs
If you are reading this and are unsure whether your thoughts are natural or warning signs that you may need support, here are some things to keep a watchful eye on: An obsession with the number on the scale, such as frequently weighing yourself; an obsession with body size or shape, or feelings of disappointment and a strong desire to fit into your pre-mom clothes; counting calories or calculating them based on how much you nurse to determine your intake. Food restriction is another red flag, which can take several forms, such as intermittent fasting, only eating certain food groups, trying different fad diets, or ordering someone’s foolproof weight loss guide. Excessive exercise, particularly when driven by a need to "compensate" for eating or to achieve rapid weight loss, can also indicate a problem. Other signs might include withdrawal from social activities, especially when food is involved; increased anxiety around mealtimes; constant food noise, a preoccupation with body-checking behaviors (e.g., repeatedly checking for loose skin on your stomach); changing outfits multiple times before going to a mommy-and-me class; or avoiding doctor appointments out of fear of being weighed. By being aware of these warning signs, new mothers and their support networks can take proactive steps to seek help and address these issues before they escalate.
To sum up this post, being a mom is already incredibly demanding and challenging. An added layer (no pun intended) of self-hatred for your body can lead to serious outcomes and trying to simply “love your body” or “feel happy for what it’s been able to do” doesn’t come easily for many people (does it for anyone in our society?). Don’t be afraid to acknowledge that you may be struggling and to voice your concerns to your partner, a friend, a doctor, or a therapist. It’s not a rite of passage to dislike your postpartum body, and you don’t have to struggle alone.
Read more about eating disorders.
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