Feeding the Pregorexia Epidemic
Two of my longstanding Google news alerts, "maternal health" and "eating disorders," recently merged when this story from an Irish newspaper on pregorexia (a portmanteau of "pregnancy" and "anorexia") popped into my inbox.
While it's not an officially recognized diagnosis, "the behavior associated with pregorexia is real and could harm a baby's health," says Roger Harms, a doctor at the Mayo Clinic. He notes that while gaining too much weight during pregnancy is still far more common than gaining too little, "no matter what the scale says…some women do excessively worry about their weight gain and experience body image issues during pregnancy."
The British magazine OK! came under fire earlier this summer for running a feature story on Kate Middleton's "post-baby weight loss regime." Even as moms around the world tweeted and blogged their appreciation of Kate's post-baby appearance, in which she seemed not to make any attempt to disguise her postpartum tummy, OK! magazine, like any good tabloid, tried to appeal to readers' venality by promising details of her "diet and shape-up plan" and a (supposed) interview with Kate's trainer, quoted on the cover, saying, "She's super-fit—her stomach will shrink straight back."
Another British tabloid, The Daily Star, recently reported the story of a London woman, Holly Griffiths, who gave birth to a healthy baby after a frighteningly thin pregnancy; Griffiths, who was diagnosed with anorexia at age 13, posted pictures of herself online weighing just 114 pounds at 8 months pregnant. Several years ago, an American woman, Maggie Baumann, restricted her weight gain so severely that her baby suffered intrauterine growth restriction and, after birth, seizures and attention deficit problems, which her doctor suggested "may have been linked with poor fetal nutrition."
I've thought—and written—of my own fear of gaining weight during pregnancy as a failure of hospitality. Indeed, pregnancy is hospitality of the most intense sort, in which the host offers her very body and blood as home and nourishment for the sake of a very small stranger. It's tempting to think that women who are fearful of gaining weight, even during pregnancy, are simply "inhospitable"; that their reluctance to gain weight is a failure to welcome their unborn baby.
As the luck of the genetic draw would have it, despite my early fears of gaining weight during pregnancy, I ended up "skinny pregnant." Severe nausea early on limited what I could keep down, and, late in pregnancy, thanks to my short torso, I couldn't manage to fit much food in my stomach at any one time. Still, I ate pretty much whatever I wanted whenever I wanted—except for the prohibited soft cheeses and undercooked meats and fish, which I craved passionately, like the forbidden fruits of pregnancy.
I was back in my regular jeans almost right away, which elicited almost as much praise from some people as did my new son himself. With that kind of reinforcement—and with the proliferation of products and programs aimed at helping postpartum women get their bodies "back"—is it any wonder that women go into pregnancy trying to keep from "losing" them in the first place? What if it isn't the pregnant woman herself who's failing to be hospitable, but the larger culture?
I was a single college student drinking coffee at Starbucks and quietly doing my assigned reading when a small domestic explosion went off right next to me. A woman, tall and blonde, with a hint of belly, carried a car seat into which was bundled a newborn. She settled herself down with a piece of cake and a latte, and seemed radiant and happy, gazing at her baby, until her husband sat down and made a half-joking remark about whether or not she really should be eating cake, what with wanting to get back into her regular clothes and all. The woman fled the table in tears, and, though it's been over thirteen years, I've never forgotten it.
Even then, in those disordered years when I would have had to think hard about whether I would rather die or gain 20 pounds—I was horrified and disgusted at the husband's words. I wondered how many women went through the nausea and heartburn and back pain that is pregnancy and all the hard work that is childbirth only to meet with the expectation that she should immediately look as if nothing at all had happened to her.
It's impossible for me to reflect on this cultural phenomenon without reflecting on the place I currently live: Malawi, Africa. Over the weekend, I had the opportunity to visit a maternity clinic not far from my home. As I toured the small but well-equipped facility, I noticed, as I always do, how the women looked. Nearly always, they look too thin, and even the ones who gave birth just that morning have barely a belly to show for it. I stepped in close to peek at one woman's freshly-born baby; we caught eyes and she grinned. I was stunned at the whiteness of her gums: a sign of severe anemia. Because a woman's need for iron doubles during pregnancy—and because getting enough iron in the diet is a constant problem for most women in Malawi—she was depleted. Health experts have identified anemia as a major risk factor for maternal mortality, so it's really no wonder that here it's a compliment to tell a pregnant woman that she's looking good and fat.
I'm not sharing this as a guilt trip; the grown-up pregnancy version of "Clean your plate because kids are starving around the world." ("Gain lots of weight because pregnant women in sub-Saharan Africa can't!") I tell this because here, the reality that life is short and often difficult is rarely varnished over with distractions.
Several months ago I sat with a group of women on the floor with a mother who had buried her newborn baby that morning; it was a ritual they were all too familiar with. At home, my own children ran around the yard, playing and laughing, and I realized with a start how quickly the time had passed since they were babies. Any time I spent worrying about what having them would do to my body was wasted time, I realized.
Life—the baby's life, the mother's life—is too good a gift to be frittered away fretting over the shape of the body that so miraculously brings it forth. Care for the body, but celebrate that life.