Fostering a Positive Food and Body Relationship During Pregnancy (Part 1)

Written by Piper Barboza Menini, RD

Disclaimer: This blog is for educational and informational purposes only, and not meant to substitute individual medical or mental health advice.

Pregnancy is a wild ride full of all the emotions! It can also be a triggering time for birthing folks due to unfamiliar and ongoing body changes, confusing nutrition messages, and frequent interactions with the medical system.

For those who have worked on improving their relationship with food and body, pregnancy can bring up a whole new subset of feelings.  And if you’re currently struggling with disordered eating or an active eating disorder, your experience being pregnant could foster incredible healing, or create new food and body worries. Wherever you are at, and however you feel (because there’s no “right” way to feel!), this blog post aims to provide practical tools and tips to help navigate your food and body relationship during this wonderful and unpredictable time! 

Navigating Weight Stigma 

Weight stigma is defined as attributing negative stereotypes and prejudiced attitudes towards larger bodied individuals based only on their body weight. Weight stigma contributes to worsened physical and mental health outcomes, avoidance of healthcare and increased risk for disordered eating and eating disorders. Unfortunately, health care providers are one of the biggest perpetrators of weight stigma- and this doesn’t go away with pregnancy.¹

Currently there is still a significant emphasis on weight gain during pregnancy.  And, the current weight gain guidelines for pregnancy are based on pre-pregnancy BMI.  This can perpetuate the experience of weight stigma during pregnancy. At present, there are limited studies on weight inclusive/weight neutral practices during pregnancy.  However studies in other areas have demonstrated that weight inclusive approaches lead to improved health outcomes.²

Another thing to consider is that weight gain guidelines for pregnancy are based on pre-pregnancy BMI which is problematic. Read more about the flaws of BMI and impact of weight-centric health care here.

• A note on pre-eclampsia:

  Pre-eclampsia is a serious high blood pressure condition that can develop during pregnancy. This may be a reason your health care provider wants to measure weight. There are other ways that pre-eclampsia can be monitored, and your provider should discuss screening for pre-eclampsia and symptoms to watch for. If you do notice sudden swelling or a noticeable weight change, this is something to inform your provider about immediately.

Reminders:

Weight loss is never recommended during pregnancy

Weight is not a good indicator of health

Pregnancy is already challenging enough and for some people, regardless of pre-pregnancy weight. The thought of being repeatedly weighed and having this be a topic of discussion can be extremely distressing.

Know that there are other ways that you and your baby’s health can be monitored, and consider these options below: 

1. If you have lived experience with disordered eating or an eating disorder, or are hoping to maintain your positive relationship with food and body, inform your health care provider. A practitioner who is patient centred will take this information into account when they are discussing any recommendations or providing general information to you. Disordered eating and eating disorders occur across the size spectrum and your concerns should not be dismissed if you live in a larger body.

2. Ask your practitioner if you need to do frequent weight checks. Depending on the practitioner, they may be open to decreasing the frequency of weight checks or not even checking your weight at all! NICE guidelines from the United Kingdom don’t recommend routine monitoring of parent’s weight at prenatal appointments. There are other ways to measure growth and health of baby and parent such as: routinely monitoring blood pressure, ongoing health screenings, fundal height, and utilizing ultrasound as needed. Discussing food choices, exercise and stress levels from a curious and compassionate lens is also a great way to check in about physical and mental health. 

3. If your practitioner insists on weighing you at appointments, ask if weight can be “blinded” (ie you don’t see or hear the number) and that it is only brought up if there is a significant concern.

Your dietitian can support you as you navigate these conversations and can advocate on your behalf by communicating with other members of your healthcare team. 

Stay tuned for Part 2 of this blog where we will explore how to cultivate a body positive pregnancy culture and gentle nourishment reminders. Sign up for our email list to have the blog sent directly to your inbox.

References:

1. https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-03202-5

2. Bacon et al., 2005; Borkoles et al., 2016; Provencher et al., 2007; Ulian et al., 2018

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