April 8, 2024

Dealing with body dissatisfaction during pregnancy

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Cass responds to a listener who is experiencing body dissatisfaction during pregnancy. She highlights that while this is relatively common, it can be a concern if it contributes to poor maternal mental or physical health. She shares strategies for managing uncomfortable thoughts and feelings about your changing body and the importance of women feeling free to share their experience of any aspect of pregnancy or parenthood without guilt. Importantly, Cass highlights some of the signs of 'Pregorexia' (disordered eating during pregnancy) and notes that professional help may sometimes be indicated. Connect with Cass:www.crappytohappypod.comhello@crappytohappypod.com
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Transcript

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This is Crappita Happy and I am your host, Cas Dunn.

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I'm a clinical and coaching psychologist and mindfulness meditation teacher

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and of course author of the Crappita Happy books. In

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this show, I bring you conversations with interesting, inspiring, intelligent

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people who are experts in their field and who have

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something of value to share that will help you feel

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less crappy and more happy. Hello and welcome to another

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solo episode of Crappy to Happy. I had somebody reach

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out to me and share that she is going through

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pregnancy and really struggling with a negative body image, really

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struggling with the changes that are happening to her body

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as she goes through pregnancy, and I thought this is

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such a relevant and important topic to discuss. You may

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or may not know that when I was in my

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private therapy practice back in Australia for several years, the

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majority of my case load were women who were pregnant

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or postpartum, and I specifically worked with women who were

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struggling with perinatal depression and anxiety and all of the

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things that go along with that and negative body image,

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feeling badly about how your body is changing and growing

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during pregnancy is significant.

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It's a significant concern.

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For many women. It is a huge contributing factor to

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postnatal depression. And we know that poor maternal mental health

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is a contributor to poor child health. And I feel

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bad just saying that, because I feel like mothers do

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not need one more thing to feel guilty about and

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feel responsible for.

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So I just want to preface that by saying your.

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Feelings are valid. You are entitled to feel how you feel.

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I don't want to for this to be one more

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thing to make you feel inadequate or not good enough

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as a mother. God knows, there's plenty enough of that around. However,

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I do think it's important to address because it is.

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It is something that I think many women experience, and

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I think many women feel reluctant to talk about. And

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there are reasons for that, So let's get that on

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the table straight up front. Anytime a woman who is

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pregnant is struggling with any aspect of pregnancy, and there

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are lots of really uncomfortable physical changes that happen during pregnancy,

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and you know, lots of changes mentally emotionally, Like there's

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a lot going on, and I feel like anytime a

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woman expresses dissatisfaction or that she is struggling, then the

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standard response is that she should just feel grateful, just

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feel grateful that she's able to get pregnant, that she's

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able to grow a healthy baby. And of course most

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women in that situation.

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Do feel very grateful.

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But adding like I said, more guilt, causing women to

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feel like they need to be quiet and shut down

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and not express what they're truly feeling.

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Is not good for anybody.

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And I feel like sometimes we go to such links

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to protect other people's feelings, to be so careful about

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how our experience or our thoughts and feelings might be

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impacting somebody else, somebody who potentially can't get pregnant, who

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would give anything to struggle with those issues that a

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pregnant woman is struggling with. But in our attempt to

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be sensitive to that person, if we're then indirectly or

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directly invalidating the pregnant person's experience, then that is not

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helpful either. So all feelings are valid, all feelings are welcome,

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and it should be allowed to be heard and to

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be expressed. I think the other thing about this is

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that it feels like such a superficial thing. We've gone

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so far in the world and in society to try

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to push back against toxic diet culture and the multi

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billion dollar diet industry that has worked so hard to

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convince women that they need to be thin and need

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to achieve this thin ideal and have this particular shape

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and sized body. And we have pushed so hard against

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that that then when a woman's body changes and she

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starts to gain weight, doesn't fit into her clothes anymore,

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bloated fluid retention, everything doesn't feel right in your body,

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and it can feel like this is something that she

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shouldn't be dissatisfied with. This isn't something that is worth

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worrying about, because we should all be happy with the

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skin that we're in and we're not supposed to feel

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bad about how we look anymore. We're over that now,

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we're past that, when many women's reality is that we

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are not past that. That we do very much care

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about how we look, and we do very much care

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about how well our clothes fit us, and our physical

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appearance is a big part of what is part of

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our identity and what makes us feel good about.

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Ourselves or not. I mean, that is just the reality.

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We can deny it or we like and we can

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wish it was different, but that is the reality for

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many women. So there was a survey done here in

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the UK a few years ago by a particular mental

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health foundation, and they surveyed four and a half thousand

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adults fifteen one hundred give or take, were women who

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had been pregnant, and they asked those women how they

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felt about their body after pregnancy, after having a baby,

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compared to before they had been pregnant. And of those women,

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forty one percent felt more negative about their body after

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having had a baby. I think only twelve percent said

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they felt more positive about their body.

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And then there was.

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Various you know, eighteen percent very negative, twenty three percent

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slightly more negative, but on the whole outputs of eighty

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percent felt more negative about their body after they had

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had a baby. So this is a significant issue that

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affects many many women. Add to that, body image and

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body dissatisfaction is just one of many factors that contribute

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to mother's poor mental health, and it is just one

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of many aspects of pregnancy and parenting that is misrepresented

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to us. I think is probably the best way to

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describe it. A big cause of women's dissatisfaction in pregnancy

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and postpartum is this gap between what we are sold,

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the pictures that we see in the media and in

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advertising and in magazines and now on social media, about

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what it's supposed to look like, what we think it's

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going to be like, compared to the reality of it. So,

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for example, we've all, you know, most of us have

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turned on the TV and we see TVs and movies

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and Huggies ads and all sorts of media representations of happy, smiling,

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giggly babies and they're always clean, and mum's got glowing skin,

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and they're a happy family and the house is tidy,

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and maybe there's lots of family support and that this

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is not the reality for many people. And so the

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reality of motherhood and pregnancy when it is physically uncomfortable,

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it's indigestion and fluid retention and sleepless nights and not

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being able to get comfortable, and it's a crying baby,

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and it's not having a shower for four days because

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you literally can't find the time, like it is not

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the magical miracle and the joy that is presented to us.

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And you know what, you try to say that to

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somebody like before they have a baby, and then you

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kind of get shut down for that as well, because

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it's like, why, why are you trying to scare me

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or why are you trying to make me feel bad?

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It's not going to be like that for me, Like

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many people don't want to hear it or aren't willing

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or able to hear it before they have a baby,

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And so this is why for most of us, myself included,

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it's really when you're in the thick of it then

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that you realize how tough it actually is.

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But I guess all I'm.

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Saying is that there are many reasons why women struggle

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emotionally physically men after having a baby and during pregnancy,

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and much of that is because the picture that we

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have of how it is supposed to be is nothing

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like the reality of it, and the body image aspect

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of it is a big part of that. We see

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images of women with these perfect little round bumps, and

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we see them snapping back into their skinny genes six

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weeks post natally, and it's just not the reality for

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most people. But if that's the expectation that we have

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set up, then that's going to cause us to feel

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really inadequate, like a failure and dissatisfied. Obviously, how much

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of an issue this is for you personally is probably

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going to depend on a lot of things, Like obviously

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everybody is very different and has their own individual personal

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history and experience. And if you are somebody who has

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struggled with body image issues even before becoming pregnant, and

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I know many women who have had experienced disordered eating

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and have perhaps recovered to a point where they have

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much health relationship with their body and with food, but

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then becoming pregnant can actually like kind of reactivate some

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of that disordered thinking and that very you know, the

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perfectionism and the control that is often tied up with

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a history of disordered eating and perfectionism in terms of

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physical appearance, et cetera. The being out of control during pregnancy,

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the fact that this craving is out of control, your

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body is changing in ways that you can't control, then

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this can kind of reactivate body image issues that have

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been may have been dealt with and may have been

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managed pretty well, so you may be more at risk

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during pregnancy. And on that, I think it is really

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important to mention that there is a condition called pregorexia. Now,

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this is one of those conditions that's a little bit

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like orthorexia, Like it's not in the DSM, but it

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is becoming increasingly recognized as a form of eating disorder.

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So in the same way that orthorexia doesn't actually have

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a criteria diagnosis in the DSM, but we know that

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it is an obsession with wellness and with healthy eating

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and really rigid food rules.

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Then pregorexia is.

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A kind of eating disorder that emerges during pregnancy, and

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it has some very specific warning signs. And if you're

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concerned about your body image and some of your behaviors

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around restricting eating and accounting calories is becoming prevalent and

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is a problem, then this is a sign that perhaps

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you need to be going and seeking some professional help

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because it is potentially very concerning for the health of

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your baby and for your own health. So the majority

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of this episode, I really just want to talk to

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kind of the standard body image dissatisfaction that many women

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experience when they gain weight and they don't feel good

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in their own skin. But I really think it's important

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to highlight what some of the science might be that

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this is an issue that really warrants some more serious attention.

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So there are some physical signs of pregerrex obviously pregorexia

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combination of the words pregnant and anorexia. But it does

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involve disordered eating at a time when nutrition is obviously

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crucially important. Restricting food intake is obviously a classic sign.

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But if you are really being obsessively calorie counting, really

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concerned about gaining weight during pregnancy, then you know, that's

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obviously a warning sign. If you are vomiting deliberately, so

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obviously binging purging signs of bulimia, and during pregnancy, many

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women do experience nausea and morning sickness and they do

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become sick. But sometimes women go down the path of

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intentional purging when pregnant, So this has been kind of

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anecdotally reported back when this was first reported on in

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two thousand and four. If you are not gaining weight,

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you know, if there is little to no weight gain

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while pregnant, that that's a really worrying sign. Obviously, again,

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every single person is different. Women are going to gain

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different amounts of weight, and the more over weight you

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are before you become pregnant, then the less weight you're

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likely to gain during pregnancy. So clearly personal factors, individual

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factors that are going to come into this. But pregnant

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women are expected to gain some weight during pregnancy, so

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if you're not, then then that's concerning. So things like

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all of the usual kind of disordered eating things, you know,

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excessive calorie counting, really compulsive calorie counting, excessive exercise routines.

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Exercise is very beneficial for pregnant women, you know, it's

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really important to remain fit and active and remain mobile

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and all of that. But excessive exercising to counter whatever

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food you're eating, manifesting in exhaustion, exercising too much, overheating,

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this is problematic. Secretive eating is often associated with anxiety

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around food and physical appearance. If you're avoiding doctor's appointments,

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So if you're avoiding your regular health checkups, if you

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have a fear of being weighed doctor's appointments, which many

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people do, that can often be a trigger for people

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who've had issues with disordered eating in the past. So

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if you're finding that you're deliberately avoiding those check ins

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for that reason, that's a worrying sign as well. So

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I have gone to a website which lists some of

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the physical symptoms of pregorexia. So if you are pregnant

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and if you know that you are concerned about weight

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and body image, you know that you kin'd of been

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concerned about what you eat, how much you eat, how

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much weight you're gaining them. These are some signs that

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you might want to just keep an eye on. So

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chronic fatigue is a very common symptom. Obviously, pregnancy is

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exhausting at the best of times, but if you're restricting

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your nutritional intake, it's going to really impact your energy levels.

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If you're feeling dizzy, have blackouts. Again, some of these

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symptoms are kind of common to pregnancy and they're common

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to eating disorders, so when you combine the two, it

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can be tricky to know how much of this is

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pregnancy related and how much of this is to do

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with restricted eating. And I'm just flagging them so that

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you'd know that these could be signs that you know

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you need to go and get some help again. Gastro

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Intestinal issues bloating, gassy, acid reflux, constipation that can be

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exaggerated if you are not eating properly and well during pregnancy.

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If you are feeling shame, if you're feeling guilty about

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weight gain, if you are really preoccupied with weight it's

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making you really stressed and anxious. If you're feeling very

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disconnected from the pregnancy, feeling detached from the experience of

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being pregnant and growing a baby, that could be a concern.

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Really obsessed with healthy eating, a bit of that orthorexia

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kind of presentation that can show up in pregnancy as well.

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So it is really important to seek support from somebody

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who has experience in this area, somebody who is a

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specialist in maybe pregnancy related eating disorders body image issues.

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So you know, talk to your GP obviously, but see

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if you're get a referral to somebody who is a

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specialist in this area, because it really is, you know,

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it's a very specific issue that you're dealing with. So,

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having said all of that, like I said at the beginning,

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this is an issue that is common to many many women,

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not necessarily those who have a diagnosable eating disorder. So

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I just wanted to flag that could potentially be an

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issue and just get back to talking about regular body

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dissatisfaction during pregnancy. If you are somebody who has always

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been very fit and healthy and active. I'm thinking about

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even tif my friend Tiff Hall.

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Who you all know. You know, her whole career.

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Has been in fitness. She's been a media personality. Her

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whole identity is wrapped up in this image of being

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a very fit, strong, healthy woman. And so you don't

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have to be a media fitness trainer, you don't have

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to be a celebrity. But if that has been a

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big part of your identity, and that has been a

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big part of the way that you manage stress, the

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way that you interact socially with people, you get joy

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and satisfaction from fitness and fitness training and focusing on

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your nutrition and health, then again, you might be more

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susceptible when suddenly all of those things are out of

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your control and you are no longer able to potentially

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engage in some of those activities that you love. Your

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body is changing in ways that are out of your control,

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combined with things like not getting sleep, a brain fog,

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all of these things that we kind of.

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Pin our identity to the things that we pride ourselves.

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On, they all can it can feel like it's all

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kind of slipping away and we're no longer the person

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that we thought we were. We feel like we're not

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ourselves anymore, and all the things that made us or

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gave us a sense of our selves and and being

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a competent person and intelligent person and a disciplined person,

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suddenly we don't have that to hold on to anymore.

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So it can really mess with your mental health. So

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I guess what I'm saying is that for many people,

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this is an issue. We need to be able to

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normalize it, and we also need to be able to

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have some strategies to help with it so that we

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feel better about it. And the answer is not to

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say to a pregnant woman, you should just feel grateful

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that you're growing a healthy baby.

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You know you're eating for two now.

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All of these things that we all hear, like a

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lot of those things really don't land well with somebody

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who is really genuinely struggling with not being able to

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fit into their clothes, with not recognizing the person that

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they see in the mirror.

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And it's not just how you look.

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I think that the issue with body image and weight

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gain during pregnancy is that it's not necessarily just about

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physically being in a bigger body. It's all the other

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physical health aspects of physical symptoms that feeling achy and

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creaky and having pain in your wrists or your knees

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and carp tunnel, and it's the indigestion and the heartburn

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and not being able to eat the things that you

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used to enjoy eating. Like, there's a whole lot of

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other stuff wrapped up that is beyond just like I

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no longer fit into my skinny genes, it's a whole

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lot of things that wrap up together that contribute to this.

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So if that is you, if this is something that

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you find that you are struggling with, or you have

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struggled with, or you know somebody who is struggling with this,

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then what can you do about it? I think some

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of the advice here is going to be very similar

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to the advice that I would give to anybody struggling

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with body image issues and body dissatisfaction. And the standard

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one is the one that we all know, is to

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focus on function. Focus on what your body is able

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to do, not how it looks. Really trying to shift

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that perspective to the fact that your body is having

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to change to grow to nurture another human being. It's

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like this is a season in your life. This is

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not forever. It is for a limited period of time

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that your body is required to change to cope with.

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And I know that you've probably told yourself this one

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hundred times. I'm not telling you anything new, but as

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much as possible kind of remembering, you know, focusing on

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and appreciating what your body is actually doing, which is

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growing and nurturing another human being. I think taking that

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kind of zoomed out perspective, you know, like looking at

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your life and yourself from like a really really really

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really high up so that you're as small as an ant,

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and looking at it from the perspective of how important

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will this be in five years or in ten years,

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you know, being able to take that step back and

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see it from records, because right now, if you're right

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in the thick of it, and it feels like pregnancy

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lasts forever, and it feels like things are never going

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to be back to how they were before, But if

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you can zoom out and take that helicopter view, then

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that can really help to shift your perspective a little

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bit and give you some sense of the temporariness of

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this particular time in your life. I would recommend that

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you unfollow any social media accounts that cause you to

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feel bad about yourself. So fitness influences who have bounced

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back into their perfect body, who are perfectly groomed and

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doing all of their post natal or the pregnancy pilates

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and with their perfect little baby bump, and that is

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not how you feel at all, then it is totally

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fine to remove all of that media, remove that from

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what you're consuming, focus on following accounts that make you

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feel good about yourself at the very least, do not

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make you feel bad about yourself. We have to take

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control of the media that we consume, and we can

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do that with social media, so do that. I would

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also highly recommend that as early as possible in your pregnancy,

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you get yourself some decent maternity clothing. You know, it's

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very tempting to say I'm just going to get through

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pregnancy with wearing my normal clothes or wearing my elasticized

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pants or whatever it might be, well fitting clothes. It's

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the way you feel in your clothing makes such a

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big difference to how you feel in your body. If

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you're wearing oversized, baggy clothes that just are like have

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no shape they're not really you know it, It might

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be economical to do that. You might not want to

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spend the money on maternity clothes you're not going to

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wear for that long, if you can borrow them, if

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you can get them.

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From thrift shops.

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Wearing well fitting clothing that are designed to fit a

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pregnant body is going to make such a big difference

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to how you feel, to how you look and how

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you feel in your body. Definitely getting rid of the

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tight fitting clothing, the stuff that's probably you know, only

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barely fitting into pre pregnancy skinny jeans, all of those things,

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getting them out. You do not need reminders of the

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things that don't fit you anymore. So move them along,

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get you know, move in the clothing that makes you

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feel comfortable, that makes you feel good in your body,

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and especially well fitting maternity clothes.

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I would highly recommend.

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The thing that I really like about acceptance and commitment

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therapy as an approach to dealing with any of these

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