Anorexia and pregnancy – Pregorexia

Since their inception, the mass media have loved to keep us updated on everything that revolves around the lives of (more or less) famous women, including pregnancy and childbirth. We talk about  vip storks  and  social pregnancies  not by chance; particular emphasis is placed on the physical appearance of these women: how many kilograms they gained, how many they lost, how long it took them, in what ways.

Whole reports are built on new mothers who have come out of the clinic where they gave birth to their child as if they had been in a  beauty farm for a week . Diets are advertised with the name of the famous one on duty, possibly to be combined with a training plan worthy of a recruit training center.

At least three conclusions seem to derive from this media bombardment:

  1. The woman, as such, must always be perfect.
  2. A pregnant woman’s body is ugly, unless it’s lean and toned.
  3. The most important thing after giving birth is to lose weight quickly.

To all this we add the old and often ambivalent cultural legacies. Pregnant women hear everything and the opposite of everything: ” now you have to eat for two “, ” the kilos lost during pregnancy are no longer lost  “, ” you don’t eat healthy enough “, ” you are too thin “, ” you are too fat “. Everyone seems to know the right thing to do.

Pregorexia: an unspecified disorder (yet?).

The word  pregorexia  is the fusion of the English words  pregnancy (pregnancy) and  anorexia (anorexia). It can be defined as a sort of ” anorexia of pregnancy “, bearing in mind however that there may be symptoms closer to other eating disorders (DCA) such as bulimia or binge eating disorder . It is a condition that does not currently find its precise location within the DSM-5, the Diagnostic and Statistical Manual of Mental Disorders. Its clinical observation is relatively recent, therefore it falls under the so-called “disorders not otherwise specified”.

A woman suffering from pre-orexia tries to strictly control her weight, during pregnancy and after.  Some warning signs can be:

  • talk about pregnancy as if it weren’t real;
  • focus heavily on counting calories and limiting them;
  • skip meals or eat them alone;
  • practice intensive physical exercise.

The risk of suffering from pregarexia is higher for those who have already had an eating disorder: for some women, pregnancy can bring back the ancient triggering factors or propose new ones. A further risk factor is represented by a disadvantaged context with little social support.

Even if the woman rationally knows that the weight she is putting on has physiological reasons, a mechanism made up of feelings of guilt, shame and fear for her own image can still be triggered. She catches signs of disapproval and disgust in the looks of loved ones and passers-by, she fears she is no longer attractive in the eyes of her partner. She is afraid of being seen as a mere reproductive tool, an incubator of a life under construction. Above all, she is afraid of never losing weight again.

Anorexia and pregnancy: some data

A  study  by the  UCL-Insitute of Child Health  in London, conducted among over 700 women, observed that about 7.5% met the diagnostic criteria for a DCA; about a quarter reported concerns about weight gain and fitness. These data can only arouse the interest of the scientific society, so that the topic of DCA in  pregnancy  is dealt with in a more punctual and structured way.

Another  study  conducted in Ireland has instead shown that the majority of the 57 women involved, while feeling the weight of social pressure, did not implement harmful behaviors to lose weight. In particular, the data obtained showed that many negative judgments came from other women: friends, colleagues, family members.

These data are still relatively scarce but they already highlight the importance of going deeper into the topic.

Pregorexia, conclusions

As can easily be understood, an eating disorder during pregnancy can negatively affect the health of the mother and the baby, both before and after birth.
There is little talk of pregarexia and it is hard to distinguish it from the whim of the pregnant woman who sees herself as fat. Some patients in the studies cited above even reported receiving compliments on their fitness, even from hospital staff, despite their evident state of malnutrition.

After giving birth, social pressures increase: the woman must immediately feel like a mother and play her new role impeccably, obviously in addition to those she already plays. If you have already had other children, you must show that you know how to manage them, together with her house; she must continue to be a companion, daughter, friend, worker. Especially in the latter case,  she must get back to being competitive  if she doesn’t want to lose her jobs or fall into the background to women in better shape than her.
What is almost never said about the famous new mothers on the cover is that they can count on a host of professionals at their service (hairdressers, make-up artists, trainers, housekeepers) and that they are exceptions to the rule.

An eating disorder during pregnancy, such as pregarexia can increase the risk of postpartum depression , triggering a vicious cycle whereby the less the woman feels she is a mother, the more she feels guilty and the less capable she feels.

Asking for help, as with  tokophobia , is difficult due to the stigma that a pregnant woman cannot be sick, or rather, has the right to be sick only for the sake of the child. Also in this case it is important to investigate the numbers of this phenomenon and implement a series of preventive and treatment strategies.

Katherine Johnson, M.D., is a board-certified obstetrician-gynecologist with clinical expertise in general obstetrics and gynecology, family planning, women’s health, and gynecology.

She is affiliated with the Obstetrics and Gynecology division at an undisclosed healthcare institution and the online platform,

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