Tuesday, October 8, 2024

Pregnancy Apps Triggered My Eating Disorder Relapse

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I was always afraid of getting pregnant. Despite knowing I wanted to have kids, the concept of growing a human terrified me. It wasn’t the responsibility of caring for another person or the pain of childbirth. I wasn’t scared of all the things that could go wrong or whether or not I’d actually like being a mom. It was something far simpler, yet profoundly complicated: I was scared of getting fat.

As someone whose disordered eating began in fifth grade and escalated to a clinical level by ninth, the thought of gaining weight — any amount for any reason — has been my metaphoric cross to bear since before I hit puberty. From skipping meals to binging and purging, eating disorders have played a supporting role in my life for the past twenty years. They haven’t always been center stage, taking the back seat during my years of therapy and intuitive eating, then becoming more prominent leading up to my wedding. But it’s something that’s always been there, hovering in the background and reminding me of what happens when I lose control… and what happens when I try to control too much.

That’s why, from the day I peed on a stick and watched it turn positive, I wasn’t surprised to find myself precariously balancing on the precipice of an eating disorder relapse. The joy of learning about my pregnancy was intertwined with a familiar undercurrent of anxiety. Before I even set up my first prenatal appointment, I worried about what would happen if my husband saw the number on the scale during our ultrasounds. Before I even told my best friend my news, I wondered if a doctor would comment on my weight.

As the reality of having a baby sunk in, I started having even more questions. I wasn’t even four weeks pregnant yet — and my ob-gyn wouldn’t see me for another four — so I did what any hormonal, newly pregnant person would do: I downloaded every pregnancy app I could think of.

With the apps installed on my phone, I eagerly entered all my information: the first day of my last period, my expected due date, and even whimsical ideas about what to call the baby. And while I was at it, did I want to track my weight? The apps were replete with reminders: “Slow and steady weight gain is important!” Navigating from one pregnancy app to another, seeking guidance and reassurance, was a double-edged sword. Instead of finding solace, I stumbled upon triggers — constant reminders and metrics about weight that reignited old fears and anxieties.

Experts Featured in This Article

Sara Pellegrino, MPH, RD, LDN, is a registered dietitian based in Orlando, Florida.

Jillian Lampert, PhD, MPH, RD, LD, FAED, is an eating disorder expert and the vice president of Communications and Brand for Accanto Health.

Aimee Eyvazzadeh, MD, MPH, is an ob-gyn, fertility specialist, reproductive endocrinologist, and the medical advisor for Proov.

The Problem With How Pregnancy Apps Talk About Weight

It was a stark realization that even in an age where information is readily available at our fingertips, not all guidance is helpful. In fact, registered dietitian Sara Pellegrino, MPH, RD, LDN, says it can even be outright harmful. “The constant messaging about weight during pregnancy can be extremely triggering for anyone who has struggled with an eating disorder or body image issues,” she tells PS. “Pregnancy is a whirlwind on your body, and watching it change can be a challenge no matter who you are.”

Despite the deeply personal nature of my fears, I soon realized I was far from alone in this struggle. Research suggests up to 7.5 percent of pregnant women actively suffer from an eating disorder, and far more than that experience body dissatisfaction during pregnancy and postpartum. During pregnancy, the risk of relapse or the intensification of symptoms can increase, turning what should be a time of joy into a period of heightened anxiety and vulnerability.

Instead of finding solace, I stumbled upon triggers — constant reminders and metrics about weight that reignited old fears and anxieties.

While the apps provided plenty of helpful information — like what to expect at upcoming appointments and what size produce my baby was that week(!) — it was the barrage of weight-related comments some of them delivered that made relapse seem inevitable, even from the start. I felt a twisted satisfaction in the weight loss that accompanied morning sickness. I subconsciously “rewarded” myself with comfort food post-doctor’s appointment after “eating clean” leading up to each visit, both sentiments deeply rooted in my history of disordered eating. Despite filtering the apps, I’d still get prompts asking me to input my weight or track my calories. I felt like the most important part of pregnancy was what the scale said and not what my body was accomplishing.

“Pregnancy apps can exacerbate [body-related] vulnerabilities through an emphasis on tracking weight and diet,” says eating disorder expert and vice president of Communications and Brand for Accanto Health, Jillian Lampert, PhD, MPH, RD, LD, FAED. “While tracking behaviors can be helpful to illuminate areas in need of attention, they can also disproportionately magnify attention that leads to obsessive thinking. Even those who have established a healthy relationship with their body image can be destabilized by messaging that emphasizes generalized expectations for what will happen to the body over the course of pregnancy and postpartum.”

What makes apps and the spread of mass information re: pregnancy and postpartum weight so problematic is the sheer number of misconceptions and scare tactics surrounding the topic, Pellegrino says.

“There are a lot of ‘guidelines’ around how much weight you should gain during pregnancy, which can cause guilt if you go over or under those,” she explains. “When someone gains ‘too much,’ they may worry about not being able to lose the weight post-birth or developing gestational diabetes. And someone who ‘doesn’t gain enough’ may worry about their baby not getting enough nutrients. A mother’s weight gain cannot solely determine the health of her, her baby, or how she will physically look after birth. Focusing on these numbers alone can cause unnecessary stress and guilt, and there are already enough stressors surrounding having a baby; we cannot let these arbitrary recommendations make us feel like a failure before we’ve even started.”

As I delved deeper, exploring both personal stories and expert opinions, it became increasingly clear that the current landscape of pregnancy apps often overlooks the nuanced needs of those with a history of eating disorders. This oversight can exacerbate feelings of isolation and anxiety, underscoring the urgent need for change, especially during the most vulnerable time of your life.

What Can a Pregnant Person Do to Stay Safe?

Pregnancy can be an extra challenging time for those with a history of disordered eating and navigating this period safely involves several key strategies. First, inform your medical team of your history. Simple steps such as turning around when getting on the scale and asking not to be informed of the number can ease some anxiety and make you feel more in control. Aimee Eyvazzadeh, MD, MPH, an ob-gyn, fertility specialist, reproductive endocrinologist, and the medical advisor for Proov, also stresses the importance of consulting with healthcare providers who specialize in both eating disorders and reproductive health; they can offer personalized guidance, ensuring that any advice or app features are tailored to your specific needs and grounded in evidence-based practices.

“We cannot let these arbitrary recommendations make us feel like a failure before we’ve even started.”

Working with a registered dietitian is also essential. Dietitians can assist in understanding how to nourish your body throughout pregnancy without focusing solely on weight. For example, Pellegrino often has myth-busting sessions with her pregnant clients, addressing misinformation from social media, apps, or even well-meaning friends with research and context. This approach helps clear up misconceptions and reduces unnecessary anxiety. A dietitian can help you find the right tools for a healthy pregnancy, both mentally and physically, providing support and strategies that go beyond mere numbers.

Lastly, be selective about the pregnancy apps you use. Avoid apps that focus on calorie counting, tracking of weight gain or loss, and detailed body measurements. Every pregnancy and body is unique, and many apps can exacerbate anxiety rather than provide reassurance. If you’re unsure whether the app you’re using is eating-disorder-friendly, show it to your doctor at your next appointment. And if that means no apps are your best course of action, don’t worry. You can still compare your growing baby to fruit — you might just have to Google it.

Can a Person Prepare Before Pregnancy to Protect Their Mental Health?

Being proactive about managing disordered eating triggers before and during pregnancy can make a significant difference. Take my friend Tori (31), for instance. She recently shared that she’s already feeling stressed about the emphasis on weight and BMI in pregnancy apps while she’s trying to conceive.

“I’m terrified that the advice that seems so prevalent on these apps will cause me to relapse into my old habits,” she says. “I’m afraid that tips on not gaining too much weight will trigger me to restrict how much I eat or that focusing on losing the baby weight will make me overly fixate on my eating, preventing me from fully enjoying the newborn stage. I don’t want my kids to see their mom hating her body because I didn’t lose the weight quickly enough after having them.”

Tori’s concerns are well-founded. Dr. Eyvazzadeh notes that pregnancy apps can sometimes lead to obsessive behaviors related to tracking calories, nutritional restrictions, and body expectations during pregnancy and conception. To navigate these challenges, it’s crucial to choose your pregnancy apps carefully.

Select apps that support your well-being and avoid those that may exacerbate your anxieties. What works for one person might not work for another, so download and test a few out, then don’t hesitate to delete any that feel triggering or off. You don’t have to track your weight or monitor calories just because an app prompts you to. Instead, follow your doctor’s guidance and ignore unsolicited advice from your screen. As I’m navigating the third trimester of my second viable pregnancy, I’m using the apps as a quick little check-in and nothing more. I scroll past any discussions of weight and instead, simply look at what produce my little one is closest in size to this week and whether or not my endless hip pain is a common symptom (it is). My doctor is the only one who needs to track my weight, not some random application on my phone.

What Needs to Change About How We Approach Pregnancy and Weight?

Ultimately, while pregnancy apps are downloaded by many parents-to-be, it doesn’t necessarily mean they’re the healthiest tool for those expecting. “Developers need to take a more informed approach regarding eating disorders within their applications,” Dr. Lampert says. “This could include incorporating sensitive content warnings for topics surrounding weight, body image, and diet, as well as customization that allows users to disable these elements completely.”

And what about healthcare providers? They need to stay in the loop, too. It’s essential for them to talk about the impact of these apps and digital media as part of their patients’ care plans. They should get familiar with these tools so they can give solid advice on how to navigate them safely. Dr. Lampert emphasizes that digital health tools are not a substitute for real, supportive relationships; instead, they should complement them.

When it comes to digital media’s influence on body image and disordered eating, research is key. We need to understand how these platforms shape our perceptions and contribute to the pressure to conform to certain body types. Algorithms don’t make it easy, and it’s not always possible to avoid triggering content, even if you’re trying your hardest.

Ultimately, “The focus should be on holistic health and well-being, rather than numbers on a scale,” Pellegrino says. Tailoring app content to reflect this mindset can help make the pregnancy experience more positive and supportive.

As I navigate another pregnancy, I’ve found that giving myself more grace — and checking my apps less — has made all the difference. While that might mean I get fewer updates regarding how big my baby is or what milestone they’ve (allegedly) hit, it’s giving me the ability to be more present and less impatient with my body. Granted, that means bugging my ob-gyn for additional checks and frequent reassurances, but hey, isn’t that what insurance is for?

Rachel Varina is a full-time freelance writer covering everything from the best vibrators (the OG Magic Wand) to the best TV shows (“The Vampire Diaries”). She has more than a decade of editorial experience with bylines at Cosmopolitan, Elite Daily, Betches, and more



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