Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...Tell Me More
Spinning nausea, wrenching vomiting and relentless exhaustion. No, we’re not talking morning sickness here (although we hope we didn’t give anyone traumatic flashbacks). This is just the everyday reaction to our media’s barrage of celebrity pregnancies. Sure, we wish all the best to anyone celebrating a new child, but the “baby bump” blitz (Did we really just say those words??), let’s face it, has nothing to do with babies themselves and everything to do with the starlets: how they look, how big they’ve gotten, who they’re wearing. (Please, please, make it stop….)
And, if you can bear with us for a few more moments, these depictions (as those of us who’ve been there especially know) are far from nitty-gritty portrayals of pregnancy reality. We’ll mercifully (and gratefully) leave the low down particulars to the entertainment blogs, but suffice it to say that expectant celebrities artfully stage how they’re depicted and most conveniently disappear from the spotlight in the final two to three (i.e. largest) months of their pregnancies. (And then there are the miraculously – or suspiciously, depending on how you see it – slender appearances merely a few weeks post-baby.) These perfect, publicity-cultivated and seemingly omnipresent portraits, many suggest, are encroaching on women’s (and men’s) perceptions of healthy pregnancy. (So much for Grok’s Rubenesque fertility goddess statues…) In fact, these selective and stylized representations of pregnancy are being criticized as contributing factors in a disturbing new phenomenon that reaches beyond Hollywood.
According to medical experts, we’re seeing a marked rise in the number of women who intentionally and dangerously restrict their weight gain while pregnant. Existing on little to no food, throwing up, exercising obsessively – these are the hallmarks of these women’s behavior. Sound like an eating disorder? Well, that’s what they’ve begun to call it. Pregorexia, in fact. Unsettling and sad as a phenomenon, to be sure. Controversial as a diagnosis to some.
One expert, Professor John Morgan, who directs the Yorkshire Centre for Eating Disorders at St George’s University in London, believes that “1 in 20 pregnant women” may suffer from pregorexia. The numbers are hard to nail down, Morgan suggests, because women rarely share their condition or disordered “behaviors” with their doctors. Any indication of low weight gain or vomiting can be rather simply excused as a result of severe or extended morning sickness.
Current medical recommendations for pregnancy weight gain vary based on pre-pregnancy BMI. According to the American Pregnancy Association, women of healthy, “normal” weight are advised to gain between 25-37 pounds. Those who are overweight prior to pregnancy should gain 15-25 pounds. Finally, women who were previously underweight before becoming pregnant are advised to gain between 28-40 pounds. (And, we know what you’re thinking. Most of the aforementioned celebrity community would likely be in the underweight category.)
Let’s be clear. The stakes here are huge. Insufficient weight gain, as defined by the APA guidelines, has been associated with poor fetal growth, low birth weight, premature birth, mental retardation, birth defects, and reduced breastfeeding. This is absolutely no way to begin a child’s life. Although we don’t often see these kinds of situations in the Hollywood set, it’s important to remember that these women choose how and when they’re seen. And although some of these celebrities might not gain as much as they should during their pregnancies, their nutrition and exercise are meticulously monitored and regulated by professionals they have the means to hire.
And the truth is, we can’t lump it all on celebrities and their image strategy. In the 19th Century, when rickets and other nutritional deficiencies contributed to smaller pelvic openings in women, doctors routinely advised little weight gain. As unhealthy as these recommendations were at the time, you could at least see the logic. This wasn’t exactly an age when C-sections were much of an option. (And when they were, it was typically to save the baby after the mother had died.) But rigid weight gain recommendations remained in place until close to 1970.
Even today, some women may feel pressured by their physicians or relatives to unnaturally limit their weight gain. Though current recommendations offer a healthier target range for women, doctors usually track expectant mothers’ weight gain with a pre-set trajectory chart based on their pre-pregnancy weight. Although these charts offer fairly reliable estimates for weight gain throughout pregnancies, pregnancies do vary. Some women, without any action or intention on their parts, might gain more in the second trimester but then level off more in the third than most women. They might be told in that second trimester that they’re gaining too much and should cut back their food intake, exactly at a time when their baby might be in a growth spurt.
The history of medical recommendations aside, some women today are so distraught over the idea of gaining the significant weight needed for pregnancy that they’ll put their children at risk for lifelong health and cognitive problems. (And themselves at risk for nutritional deficiencies.) Ultimately, pregorexia (like other eating disorders) perhaps has little to do with the number of pounds and more to do with a desperate grasp for control over the extraordinary anxiety some women feel when pregnant. Many if not most women who are diagnosed with the disorder have suffered from an eating disorder in the past. As Liz Fraser, who was diagnosed with the disorder, explains, “Pregnancy is a frightening and disorientating time and new motherhood is for many women an assault on identity and on everything you’ve ever known. Some women get depressed, others get eating disorders. Many get both. My eating disorder became my coping strategy – a habitual response to stress since I was a teenager that kicked in again when I felt vulnerable during pregnancy.”
Health, of course, is ultimately about working with your body’s natural inclinations and navigation toward balance and homeostasis. It goes without saying that a careful, healthy diet and safe exercise practices are crucial. But pregnancy, perhaps, also depends on a kind of individual perceptiveness. Trusting yourself and getting comfortable with the difficult and indeed “disorienting” physical and emotional process can be just as key to a healthy pregnancy – for every expectant mother but certainly for those at risk for pregorexia.
We’ll turn it over to you now. We’re interested in hearing what you have to say. Have you heard of pregorexia before? What are your thoughts, perspectives, critiques, questions, reactions?