Real Talk: Pregnancy, Eating Disorder Recovery, and Crohn's Disease

I want to share my experience, not to provide a solution, but to provide an honest perspective that maybe you can resonate with. For years I have been interested in the correlation of digestive diseases and eating disorders, specifically the lack of dual diagnosis holistic treatment options. Throwing pregnancy into the mix is a whole new game that has me digging even deeper based on my personal experience. How do we deal with the mind fuck of weight gain and body changes while in recovery from an eating disorder? On top of that, how do we manage dietary restrictions or triggers from a digestive disease in addition to the restrictions and symptoms already brought on by pregnancy? Again on top of that, how do we deal with the emotional triggers that are drudged up by these changes and the added pressure of supporting a new human life? There are a lot of questions I want to explore, but right now what I have is my story and how I have navigated it thus far. 

A struggle for me in my pregnancy has been eating, specifically what to eat and how to eat enough. My background doesn’t provide the best foundation for a great relationship with food in general, but because of that I’ve worked my butt off to get to a good spot. For those who haven’t read my other posts,I struggled with an eating disorder and then on top of that my Crohn’s diagnosis fueled additional struggles and triggers. I remember in eating disorder treatment, being there with other women who were struggling with how their bodies changed during or after pregnancy. When I thought of having kids, I always braced myself for this new reality.

When I figured out I was pregnant, all of my healthcare professionals who knew my background immediately began asking me how I felt about the weight gain and my body changing. It was so early on I really didn’t have any issues, plus, I hadn’t gained any weight.

During my first trimester my digestive system was a complete wreck. I had nausea that would never go away. I would try to force myself to eat and just ended up gagging instead, unable to get anything down. My new growing baby was messing with my intestines which brought on some new Crohn’s symptoms. Things were a mess, but it was trimester one so I figured it was par for the course.

At my 12 week appointment, my OB brought up that I had lost a significant amount of weight. I was pretty caught off guard by this since I try to refrain from weighing myself at home, as that is a trigger for me. I also didn’t understand how I had lost so much weight when the only things I could stomach when feeling up to it were gluten free cupcakes and Lucky Charms. We talked about it, but it wasn’t a huge concern yet since I was hopefully going to graduate out of the nausea soon. As I left the office I remember feeling a pang of guilt because was actually proud to have someone concerned about my weight loss. That brought me back to the time when that kind of feedback fueled me. I didn’t necessarily feel guilty for having this thought.  They happen and you live with them and move on. I felt guilty because I wasn’t trying to lose weight. I was doing everything in my power to give my baby all of the necessary nutrients to grow. I felt like I was failing and having these thoughts made it worse.

My doctor seemed pretty confident that my body would sort itself out over the next few weeks so I tried to push the worry from my mind. The main struggle I was having was the food that I was craving, I know I couldn’t have because they would trigger my Crohn’s. Things like donuts, waffles, and sandwiches are always a no go for me because of the gluten (yes you can get them GF but no where near the same). I worked to find gluten free options but a lot of those are heavily processed though so that brought in more concerns of messing with my digestive system. I also felt shame for relying on processed foods since I was supposed to be giving my baby the best nutrients. I felt like no matter what I did, I was doing something wrong. Everyday I woke up in a stress fog of what the fuck do I eat today… what the fuck CAN I eat today. I also was balancing the regular pregnancy restrictions on top of those to save my digestive system. For example, I was disgusted by meat and could only stomach seafood, but I had to limit how much seafood I ate. I was seriously struggling to get enough protein. 

During this time when I was going through my food crisis, we were also going through a global pandemic. Over these weeks I just mentioned, I also had to relocate from my house, live apart from my husband, and wasn’t able to go out in public to grocery shop for myself. This added a whole new layer onto the problem. I know this part of the situation is not relevant for everyone, but I felt it worth mentioning because it had a big impact on my life at the time. I was out of my routine, I was stressed, and I was just trying to get by. This triggered some increased Crohn’s symptoms to even further complicate things. 

When I saw my doctor again, she brought up the lack of weight gain and actually more weight loss. I walked her through my struggles and she basically told me to just eat whatever I can. The baby will be fine if its McDonalds fries or a vegan smoothie bowl. He just needs to get fed. This made me feel better about what to eat, but didn’t change the fact that I rarely felt like eating. (Quick side note here: my doctor did prescribe me anti nausea medication, but it made me so drowsy I could only take it in the evenings. I would pass out immediately so while it is great for sleep, I can’t eat while I am sleeping.) Another issue I had was my natural reaction to not eat when I was having Crohn’s symptoms. Over the past however many years, it is like I have been conditioned to avoid that pain. My stomach hurts, naturally I stop wanting to eat to avoid the pain. In those situations I revert back to liquid or soft diets until my inflammation improves. I knew my child would not be okay if I spent the next 6 months eating chicken broth and popsicles. I mean I would not even be okay if I had to do that. The discomfort I was feeling also just caused me to not feel hungry almost ever. I never thought I would be this person, but I had to remind myself to eat. I think this was escalated by me working from home and being in an environment where there was no designated lunch hour where everyone is grabbing something to eat together. I could work through the day and not even think about lunch. 

I worked with my doctor to come up with a solution of supplementing my diet with Ensure shakes. These were easy for me to get down and digest, plus they would help with my protein intake. Now I want to pause here for a second. I know there are people reading this that will be mentally shaming me for not choosing a natural option or not creating a protein smoothie for myself at home, blah blah blah. Look, this is what worked for me and my life so that is that. These have been a lifesaver for me throughout this pregnancy. Of course, I don’t just drink Ensure, but knowing I have that as a safety blanket has allowed me to relax and listen to my body more on what it actually wants. It is pretty funny to me that I have seen Ensure as such a helpful tool. When I was in eating disorder treatment it was the bane of my existence. I would (not electively) drink four of these a day on top of my meals to get back to a healthy weight. I swore I would never touch them again after treatment, but now look, they are helping fuel my pregnant body and help my baby grow. Oh how the tables have turned. 

My nausea and discomfort subsided a bit for the latter part of my second trimester and a quick bit of my third, but are now back in full force. I also am feeling the effects of being off of Remicade this trimester so that has added some more turbulence to the situation. I am struggling to identify which symptoms are a result of pregnancy or a result of Crohn's. Right now the cause isn't necessarily my worry, it is how I am going to make this work for the rest of the pregnancy.  I have gained weight which my doctor was pleased with and it really hasn’t bothered me as much as I was worried it might. I haven’t gained a ton of weight, but enough to be on track. I am told I should feel “lucky” that this is the case. Yeah, I guess I feel lucky, but I also feel ashamed that this has been and continues to be such an uphill battle. I can’t help but wonder, how would I feel if this wasn’t the case and I did have a normal weight gain during this pregnancy? Would things feel easier or would other feelings be triggered?

To be really honest, I have had countless breakdowns crying on my sofa frustrated about food over the past 8 months. I’m in pain, but I need to eat, but I don’t want to eat and everything I actually might want will make me sick so then I’ll feel worse, but then baby needs nutrients but if I’m sick that hurts him too so what the fuck do I even do. There have been lots of tears and lots of my sweet husband showing up with ice cream, one of the only things I can almost always stomach. He doesn’t understand necessarily what I am going through, but he makes the effort to help in any way he can which is more than enough for me.

It is difficult to unpack all of the emotions that are a part of this journey. I reflect daily on how I am doing and have an honest check in with myself to make sure I am not drudging up old patterns of thinking. It’s hard, but I am confident in the work I have done and the strength that I have. This situation has forced me to revisit painful thoughts and walk through guilt and shame and I’ve decided that is okay. Pregnancy is not a mutually exclusive event and we are still handling other things, physically and emotionally as we go through it. At the end of the day, I think we need more answers on how to support pregnant women in these situations but I don’t know if those solutions are coming anytime soon. This highlights even more the importance of taking care of your own mental health as you prepare for and go through pregnancy. Find others who are going through the same thing, see a therapist, rely on your support system; do whatever you have to do, feel what you have to feel, and most importantly know that it is okay. 

f you or someone you know is struggling with an eating disorder, please check out the NEDA website for details on resources and treatment options. 
xx