ATTENTION! - Never, ever, EVER, ask a woman if she is pregnant just because she is gaining weight. No seriously. Don’t do it!
When I first entered treatment for my eating disorder I did a lot of research to see what I was getting myself into. I wanted to know what to expect, what not to expect, the good, the bad and the ugly. One tid-bit that kept popping up as I googled for hours, was the “pregnant belly.” From what I read, it seemed like a substantial amount of people in recovery, gained a large amount of weight in the belly area, leaving them looking pregnant. I was terrified of this happening to me…..and unfortunately it did.
Since I am not an expert, scientist or doctor, I won’t go far into the science of the “pregnant belly.” I don’t want to act like I have all the answers. However, I will give a brief run down, in my own words, of what this is and why it happens. This is based on what I’ve learned as well as from my own experience. I will also, at the end of this blog list a bunch of studies and articles about this in case you want to learn more from actual experts!(1) Basically, when a person recovering from an eating disorder begins the re-feeding process, the body tends to distribute a lot of fat in the belly/trunk area first. (2) There are a few reasons that I have read as to why this happens.
First, the body is about to go through a major restoration/healing process so it is storing up fat in order to protect the area that it is about to heal. There are vital organs in the trunk area that have been harmed and they need to be kept safe in order to heal. The body is also saving up a ton of nutrients in order to get the job done. My eating disorder, for example, effected my kidneys, intestines, stomach, heart, bones etc. My body wants to protect these organs as they go under re-construction!
Another reason this happens is that our bodies do not trust us yet. I was anorexic and exercise bulimic for seven years before entering treatment. That means that my body was not getting enough nutrients for a very long time, and my metabolism had basically halted in order to keep me alive. So, not only is my metabolism very very slow, it is also storing up extra fat, near my vital organs, just in case my body goes through another famine. Our bodies are SMART. It won’t let go of this fat until it feels sure another famine is not coming. This takes a VERY long time. Thus one of the reason recovery is very long. Also the reason many of us overshoot our normal weight and then it comes back down. (1)
Hormones can be another reason for this happening. My hormones are all out of whack because of the eating disorder and lack of nutrition, leaving my body to distribute fat differently. One study found that patients with prolonged malnutrition have uneven fat distribution. The reason why is, “A decrease in gonadal steroids has been reported in anorexia nervosa and may also contribute to the preferential fat distribution encountered in our subjects. It is well known that estrogen and progesterone modify body fat distribution by increasing peripheral or subcutaneous fat deposition” (1) The good news however is that over time, with continued nutrition and maintaining a normal body weight, the body will normalize and redistribute this fat. Our bodies are so cool! Again, this can take years..
Now that we all understand what can happen and a brief description of why, lets get back to why you should NEVER, EVER ask a woman if she is pregnant.
When I started re-feeding I noticed that the “pregnant belly” was starting to appear. I was gaining most of my weight in my mid-section and on top of that, I was swelling up every time I ate. I began to have EXTREME anxiety over this belly and there was nothing I could do about it. I decided to wear stretchy pants and very baggy dresses to hide the belly. “Normal” sizes wouldn’t fit anymore because my body shape was more like that of a pregnant woman. (sidenote - I did at one point try on pregnancy pants and they fit great…but I just couldn’t bring myself to buy the, because ...I’m not pregnant!) I began to isolate myself at home for fear that someone would ask if I was pregnant. When I did drag myself out of the house I made sure that my belly was as hidden as it could be, but alas, the inevitable happened and I'm not going to lie, it was devastating….
When you ask someone if they are pregnant, typically there are two ways that they are going to answer you….
YES! Then you smile, congratulate etc. etc.
NO... Which is then followed by an extremely awkward few minutes, maybe an apology, some weird excuse to leave the conversation…cricket...cricket....
The first time that someone congratulated me on my “pregnancy” I just about died. I was rounding a corner, not even thinking about it, and then I heard, "CONGRATULATIONS!!” I don’t know why, but my first reaction was to say, “On what??” I knew exactly what they were talking about. I felt dizzy. I couldn’t concentrate. My heart was beating a million times a second. I had a very deep sense of shame and embarrassment and all I wanted to do was run, hide my body under the covers in the safety of my bedroom, and stay there. Obviously I couldn't do that. Instead I had to go through the torture of a conversation that honestly should have never happened.
After I said, “On what,” I figured the person would be smart enough to realize they had made a grave mistake. A pregnant woman does not say, “On what?” when told congratulations…..but no.. they proceeded to say, “On the baby!!” In which I replied, “I’m not pregnant.” Cue their look of horror....Cricket. Cricket. In order to save us both from further damage I quickly and simply told the person I was having some health issues, and it was causing me to gain a lot of weight. They responded in a concerned way and then proceeded to defend their mistake by saying that at least their intentions were good, and that if I was pregnant they would want to celebrate! Moron.
After this encounter I basically went inside my home, laid in bed, and cried for an entire day…maybe two…it honestly might have been three. It was bad. There are a few reasons why this was so devastating.
First, it solidified that I was gaining weight, and I had gained enough weight that someone would think it safe to ask if I was pregnant. There is a certain amount of denial when the weight gain begins. It's obviously there, but its hard to acknowledge it and you pray others are magically unable to see it. Gaining a substantial amount of weight, quickly and unevenly is terrifying. The weight gain, was and is, my WORST nightmare come true. Having someone point it out by asking if I’m pregnant is probably THE MOST embarrassing moment of my life. When I was congratulated on my non-existent pregnancy, it felt like this person was basically just calling me fat and pointing out that I no longer was thin and fit. Obviously if someone fit gains weight the only logical answer for this would be pregnancy…not the myriad of other possible things, like health issues. It also made me have to acknowledge my large weight gain, out loud, to someone I barely speak with. Which I’m sure everyone can understand, is not something I’m excited to do.
Second, it left me in the bad position in which I felt forced to reveal a very personal and private health problem. There is a reason that I got off social media for almost a year. There is a reason I didn’t put on spandex and walk around the neighborhood screaming, “I’m recovering from anorexia and exercise bulimia!” It was nobody’s business. Recovering from an eating disorder carries a lot of shame, especially in the begining. It also is very difficult and most people don’t understand it. Therefore it was in my best interest to keep it very private until I had the ability to cope with other people knowing my private business. This is difficult because the weight gain is obvious and people are nosey. Since I wasn’t pregnant and didn’t want them to think I just sat home eating Pringles all day, I felt forced to share this very personal information with people that I actually barely had a relationship with because they thought it appropriate to talk about my body. Not only was I called pregnant, but now I have to say, nope, not pregnant. I'm just fatter and it's because I'm recovering from an eating disorder.
Third, and this is a very personal thing I’m about to share, so please use this information with sensitivity. As of today, I can’t carry a child. Unless God chooses to bless me in a miraculous way, one of the consequences to my eating disorder has left me, for now, unable to have a baby. I honestly don’t have the right words to describe the pain of this and I also don’t want to get into the logistics as to why I can’t, it’s private and complicated. To keep it simple, I am mentally and physically not in a place where I can carry a healthy pregnancy. So, having someone congratulate me on something that I, at the time, was mourning and confused about, was excruciating. I have come to learn that God has a plan for my life and that his plan is good. If it is in his will for me to have a biological child in the future then I’m confident he will heal my body and mind and it will happen. If not, there are other avenues to consider to have a child, such as adoption, and we will possibly consider that avenue once I am recovered. Either way, you don’t know what someone is going through, so asking them if they are pregnant because they gained weight, can be a much deeper issue then basically pointing out a fat belly.
Eventually, I crawled out of bed, took a deep breathe, dried my tears and moved forward. Unfortunately, while it was the first time this happened, it was not the last. Over and over again I was congratulated or asked when I was due. I continued to feel the embarrassment and shame and hurt just as strong each and every time. For some reason you just don't get use to something like this!
After this happened many times, I decided that I could not continue to go on like this. I couldn’t hide in my house for fear of someone commenting on my weight or belly. I couldn't turn back to anorexia to lose the belly. I couldn’t live in shame and insecurity because my body was healing the damage I had done to it. I needed to find a way to accept this and even be ok with it while my body went through recovery.
The third time that someone asked me when I was due, I called my mom in tears. After calming me down she gave me the advice to, even though it would be hard, start telling people about my eating disorder and recovery. Look, the unfortunate truth is people talk. They gossip! You tell a handful of people something and they all tell a couple and so on. The point was, even though I felt like I was revealing something very private that I was struggling through, at least people will know the weight is from recovering not from pregnancy. The good (and bad I guess) news is, it worked! I started to share with a few people what I was going through and before I knew it, it seemed like everyone knew and the pregnancy questions became less and less! (Although the diet opinions came more and more...and that's a story for another day..)
Another way that I dealt with it was to open up to my therapist and my support group. At one of my support meetings I finally revealed what was happening, the shame I was feeling and how anxious I was to be out in public because of it. I came to find out that at least one other girl was going through the exact same thing. I felt a sense of relief that I wasn’t alone, and I was able to vent with someone who could relate about how awful people are sometimes. We cried about it together and then laughed about it as we came up with all the snarky hypothetical ways we could respond. Even though we would of course, never say them out loud! For example, someone says, “Congratulations on your pregnancy!!” We respond, “Congratulations on being an idiot!” I know, I know…that wouldn’t be nice, but can you imagine?! haha
I also came up with a better response then, “On what?” Multiple times when I was asked when I was due, or congratulated on my pregnancy I would simply say I’m not pregnant, there would be awkward silence, sometimes an apology, and then we would say our goodbyes. When people didn’t even have the ability to apologize, I would feel like a deep injustice had just occurred. How dare this person ask something so personal and intrusive, not apologize, and get away with it? I didn’t want to be mean but I hated that I never had the guts to say anything more then, “I’m not pregnant,” "It's ok..." and then walk away in shame. Why should I feel bad because of someone else lacking in proper manners? My therapist helped me come up with a response that got the point across, was factual, kept me from being rude but also empowered me by standing up for myself. I now simply reply, “No, I am not pregnant. I am currently recovering from anorexia and that was very hurtful,” or “No, I am not pregnant and your question is extremely personal for our level of a relationship.” Yes, I could just let it go, but honestly, some people need to learn the hard lesson that you don’t ask someone if they are pregnant just because they have gained some weight!
Then there is good old acceptance. Acceptance is the last way I truly was able to deal with this issue. I accepted that this was what my body was going to do in order to heal. I accepted that, because I have been married for nine years and don’t have kids, when I gain weight, people will automatically assume pregnancy. I accepted that I couldn’t live under a rock and would have to go out in public, big belly and all. It was hard, but I accepted it.
Here is the thing, I know that most of the people who ask when I’m due or congratulate me have good intentions. They do want to celebrate with me and be excited for me. I get that. They aren’t evil people. They aren’t being malicious on purpose, AND, it still hurts and is extremely embarrassing.
I hope if you are going though something similar I have given you the validation of how hard it is, and that you are not alone. Our bodies are going through something very different and difficult. The healing process isn’t all sunshine and rainbows. The weight will eventually redistribute and the “pregnant belly” will (cross my fingers) go away. In the meantime if someone asks when I'm due, I respond how I've practiced and call them an idiot in my head! It is SO important to never assume someone is pregnant simply because they have gained some weight. There are many other reasons weight gain happens, and even if you think they might be, try to remember to never, ever, EVER ask a woman if she is pregnant or congratulate them on the baby, unless they have told you first!
I will leave you with these for a laugh…
- Sara -
1. RESOURCES - Click on any resource to read more.
Body fat distribution before and after weight gain In anorexia
Body Composition Changes in Anorexia Nervosa: A Review
Phases of Recovery From An Eating Disorder Part 4
Phases of Recovery From An Eating Disorder Part 5
Study Review: Minnesota Starvation Experiment
Eating Disorder Recovery: Aim to Overshoot
2 - I want to clarify that not all persons recovering from an eating disorder go through this, however it is very common.