You’ve grown a baby and brought new life into the world - is there anything more amazing?

Pregnancy and birth are incredible, but that doesn’t make it easy by any means. With all the joy that is expected with a new baby, you may be surprised with the reality of what you are facing postpartum.

The truth is that after baby comes, there are stressors that could make you more susceptible to a postpartum eating disorder. As wonderful as it is to have a new baby, the transition into motherhood can undoubtedly be considered a stressful life event.

Many women don’t realize that postpartum is the riskiest time for poor body image and disordered eating behaviors. Without awareness and resources for support, this can escalate to more problematic issues, including full-blown eating disorders and other mental illnesses.

If you are struggling with eating and the way you feel about your body after you’ve had your baby, know that you are not alone, mama. Let’s take a closer look at some of the signs of a postpartum eating disorder and ways that you can connect to the help you need.

What Causes Postpartum Eating Disorders?

First, it’s important to understand some of the factors that might cause a postpartum eating disorder. Eating disorders are often triggered by many different things, which come together to create the perfect storm.

If we’re being honest here, it’s easy to see why the postpartum phase of new motherhood can be a vulnerable time for mental illness, including eating disorders. Some of the factors that can increase the risk of a postpartum eating disorder include:

Eating Disorders During or Before Pregnancy

If you struggled with an eating disorder before or during pregnancy, this may increase your risk of having a postpartum eating disorder, which is up to 2 years after birth.

Some moms with eating disorders during pregnancy may be able to maintain some sense of remission to protect their babies.

The birth of the baby itself can trigger a return to pre-pregnancy eating disorder behaviors, as a mother may no longer have a fear of directly affecting the baby. Examples of active eating disorders that can surface before, during, or after pregnancy include:

• Anorexia Nervosa

• Bulimia Nervosa

• Binge Eating Disorder

• Orthorexia Nervosa

• Avoidant Restrictive Food Intake Disorder (ARFID)

• Rumination Disorder

• Purging Disorder

Birth Trauma

Research has found a strong connection between trauma and eating disorders. Having a traumatic birth can lead to a difficult postpartum experience and increase risk of an eating disorder along with other factors. Studies have found that up to 35 percent of women report their birth experiences as traumatic.

For a mother who has had a history of an eating disorder, a traumatic birth experience can be a major risk factor for a postpartum relapse.

Co-occurring Perinatal Mental Illness

It has been estimated that up to 1 in 5 new mothers will suffer with a maternal mental health disorder, such as postpartum depression or anxiety.

Mental illness often co-occurs with other conditions - meaning, that if a new mom is facing other mental health concerns, this can be a risk factor for a postpartum eating disorder.

Physical Body Changes

Postpartum moms face dramatic changes in their body in a short time period from pregnancy and childbirth. For many women, these changes can be distressing and difficult to cope with.

Combined with societal pressures to quickly “lose the baby weight”, many postpartum women experience a drive for rapid weight loss that involves dangerous eating and exercise behaviors.

Emotional Stressors

The transition into motherhood creates emotional stress for women who are adapting to caring for their babies. Becoming a mother brings a changing identity that causes shifts in relationships, careers, self-awareness and more.

These evolving changes bring emotional stressors that can be difficult to cope with during pregnancy and postpartum. When everything else around you is chaotic, it’s easier to focus on something that you feel like you can control. For many postpartum women, this includes their food and their weight.

Pressure to Breastfeed

Many new moms face an overwhelming pressure to breastfeed their babies, to the expense of their own mental health and well-being.

This added pressure along with breastfeeding challenges or the perceived inability to breastfeed can complicate a mom’s own ability to feed herself well.

The feeding relationship with a mother and her baby is an important one, and when breastfeeding is complicated, this can be an added stressor for a mom susceptible to a postpartum eating disorder.

Weight Stigma or Weight Shaming

In a weight-centric and fat phobic society, it’s not uncommon to hear comments about weight and body changes through pregnancy and postpartum. These may come from health professionals, family members, or friends.

Even if well-intentioned, comments about a new mother’s body are never acceptable. Weight shaming or being the victim of weight stigma, especially in the perinatal healthcare system, can be incredibly triggering, especially for a woman who may already be susceptible to developing an eating disorder.

Food Insecurity

Having overall lack of access to adequate food, especially when caring for children, can be a risk factor for an eating disorder.

Research has found that food insecurity is associated with significantly higher levels of binge eating and overall eating disorder pathology.

Dieting Postpartum for Weight Loss

Postpartum moms who are dieting for weight loss may put themselves at risk for an eating disorder. Many moms may begin restricting their food or over-exercising as a way to cope with their changing body from pregnancy.

However, dieting in any form is a risk factor for a postpartum eating disorder. When a mother feels unfamiliar in her new body after having a baby, the pull of dieting can bring many false promises.

Family History of Eating Disorders

Women with family members who have suffered with an eating disorder may be at higher risk for having an eating disorder themselves. Genetics plays a strong role in eating disorder development, and family history of mental illness can increase susceptibility, along with other factors.

Lack of Support

Mothers who lack supportive relationships or who have little to no help in caring for themselves and their babies can also be an increased risk for a postpartum eating disorder.

Eating disorders that develop during the postpartum period are often the result of many different factors working together, as described above.

What signs might reveal that a mom is struggling?

Women with eating disorders in postpartum may show behaviors after having their babies that could indicate a problem that needs more attention.

7 Common Signs of a Postpartum Eating Disorder

It’s important to understand that people with eating disorders experience these mental illnesses differently. There is no one single set of criteria that can be used to classify a postpartum eating disorder, as every mother will have a unique and individual experience.

Eating disorders do not discriminate; meaning, these mental illnesses can occur in moms from all different cultures, races, socioeconomic backgrounds, and more.

It is also crucial to understand that weight alone is not a criteria to determine if a mom might have a postpartum eating disorder.

Women struggle with eating disorders in every different body type. The weight, size or shape of someone’s body can’t tell us what is going on inside.

While these signs below may indicate that a new mom needs more help and support to overcome a postpartum eating disorder, this list is by no means exhaustive.

If you are a new mom and have found yourself struggling with eating or caring for your body to any degree, that is enough of a sign to get help.

Don’t believe you are “not sick enough” to get help. With that in mind, here are some signs of a postpartum eating disorder:

1. Disconnected from baby, difficulty bonding:

Moms who struggle with eating disorders during pregnancy and postpartum are more likely to have a harder time bonding with their baby. There may be a poor infant attachment between mother and baby.

Moms who are having their own eating difficulties during the postpartum period may be less in tune with and responsive to what their own babies need, including hunger and feeding cues.

Additionally, postpartum mothers who are having a difficult time accepting their changing bodies may find it less tolerable to have their babies be dependent on them.

These factors can negatively affect the bond between a mother and her infant.

2. Obsessive with exercise:

In desperation to change her body, a new mom dealing with an eating disorder may overexercise or become obsessive about working out soon after having her baby.

While it is necessary to have a period of healing and rest after pregnancy and childbirth, a mom with an eating disorder may find it difficult to sit still.

It’s not uncommon for moms dealing with a postpartum eating disorder to become obsessive with exercise to the point that it disrupts their ability to live.

Exercise often competes with other important activities and responsibilities.

A new mom with a postpartum eating disorder may prioritize exercise over other things in her life and will often continue to exercise at the expense of her own health and healing. Moms might feel like they can’t eat unless they have “earned” their food or feel like they have to workout in order to eat anything.

3. Erratic eating patterns:

Abnormal eating behaviors and patterns can be characteristic of a postpartum eating disorder. While this can vary based on the individual, some common red flags include:

• restrictive eating

• cutting out entire food groups

• limiting or counting calories

• chronic dieting

• chewing and spitting out food

• binge eating

• chronically eating to a point of sickness

• self-induced vomiting after meals

• overexercising after eating

A new mom engaging in any type of erratic eating patterns may be dealing with a more severe issue.

4. Hyper focused on changing body, weight loss:

Body changes are a normal part of the postpartum experience and the transition to motherhood. However, moms with a postpartum eating disorder are usually less able to cope with these changes.

They may hyper focus on certain aspects of their bodies, like their stomachs, and be preoccupied with weight loss and changing their body.

They may weigh themselves constantly or body check to measure any changes.

Thoughts of weight loss can become obsessive to the point that it is distracting and deterring from normal activities.

5. Preoccupied with food:

New moms who are engaging in erratic or restrictive eating patterns will often feel preoccupied with food.

They might worry about what to eat, when to eat, and how much to eat.

Thoughts about food can feel incessant and will often take up the majority of their mental space, making it difficult to focus on other things.

Preoccupation with food is a primary symptom of an unhealthy relationship with food that should not be ignored.

6. Isolation from loved ones, social activities:

A new mom dealing with an eating disorder during the postpartum period may find it challenging to engage with other people, including those closest to her.

She may isolate from family and friends, and stay away from social activities she used to enjoy.

The reasons are primarily due to her insecurities in her own body, preoccupying thoughts about food, and erratic eating habits.

A new mom engaging in restrictive eating may avoid any type of activities that involve food or having to eat in front of other people.

7. Poor, negative body image:

A new mom struggling with a postpartum eating disorder may find it intolerable to be in her own skin.

Dissatisfaction in her own body may be insufferable to the point that it is negatively affecting other aspects of her life.

She may stop seeing friends, avoid going out in public, ashamed to have sex with her husband or partner, or unable to care for herself and her baby.

The type of body image distress that a new mom with an eating disorder might experience is often debilitating.

Risks of a Postpartum Eating Disorder to Mother and Baby

The risks of a postpartum eating disorder cannot be understated, as this directly impacts a mother, her baby, and her entire family unit, including other children in the family. Some of the direct risks of a postpartum eating disorder include but are not limited to:

• Difficulty bonding, risk of insecure mother baby attachment

• Breastfeeding challenges

• Prolonged recovery: lack of nutrients postpartum due to dieting or overexercising can make it difficult for a mom to recover and heal from pregnancy and childbirth.

• Malnutrition

• Increased risk of perinatal mental health disorders, like postpartum depression and anxiety. One study found that nearly half of women with eating disorders struggled with postpartum depression.

• Family conflicts, strains on relationships

How can I Prevent a Postpartum Eating Disorder?

Many of the environmental, biological, and psychosocial risk factors associated with an eating disorder are not necessarily preventable. However, there is power in awareness, planning, and preparation.

Women with identified risk factors, as described above, can put things in place to help minimize their risk of developing a postpartum eating disorder or for experiencing a relapse into past eating disorder behaviors.

Here are some tangible things that can be done to help prevent a postpartum eating disorder:

• Understand your risk: If you are unsure if you are struggling with an eating disorder, please consider taking this free screening at the National Eating Disorder Association.

• Avoid dieting at all costs: Dieting is a major risk factor across all eating disorders. While other risk factors may not be controllable, like family history and birth trauma, you can help mitigate your risk by choosing NOT to engage in dieting behaviors. There are far more effective ways to cope with stressors and your changing body.

• Throw out your scale: If you are susceptible to an eating disorder and weight changes, please throw out your scale immediately. Weighing yourself is often a trigger for destructive behaviors.

• Create a Postpartum Care Plan: This is something that should be done in pregnancy and ahead of your baby’s birth, if at all possible. It’s important for you to put a plan in place for how you intend to care for yourself: physically, emotionally, and mentally. You MUST anticipate that there will be greater stressors ahead. You need to be prepared to counter these stressors with effective coping strategies.

• Accountability: Eating disorders are secretive diseases that thrive in isolation. If you’ve managed to keep you struggle under wraps thus far, you are not accomplishing anything beneficial. Yes, eating disorders are often shrouded in shame and stigma. But in order to help yourself and your baby break free from this, you need to break the silence and get the help you need.

• Get Professional Help: If you know you are at risk for an eating disorder, please take the time to connect to professional help, including maternal mental health professionals who specialize in eating disorders, such as registered dietitian nutritionists and psychotherapists. You do not have to do this alone. Many organizations, like the National Eating Disorder Association and Postpartum Support International offer free hotlines and directories with professionals you can connect with. You can also directly contact your health insurance for a referral or ask your OB or midwife to connect you with a professional who can support your care.

If you are struggling with a postpartum eating disorder, it is important to understand that this is NOT YOUR FAULT. Eating disorders are not a choice; However, you CAN choose to write a different story for yourself, your baby, and your family by connecting to the help you need.

If you are stuck and don’t know where to start, please connect with me today to learn more about working with an eating disorder dietitian during pregnancy and postpartum. I would love to hear your story and learn how I can help.

If you are a new mother or mom-to-be in eating disorder recovery, consider joining our free virtual support group, Lift the Shame. You can find out more and sign up through the link below.

Most importantly, know that there is absolutely hope for a full and lasting recovery and that you are not alone.