Treatment of pregorexia, pregnancy-related eating disorders

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Pregnancy-related eating disorders, also called pregorexia, encompass any eating disorders that occur during pregnancy and childbirth. (1) Pregorexia is often misunderstood and underdiagnosed, but there are treatment options available to help heal those living with the condition.

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Levels of care for pregnancy-related eating disorders

Each person living with a pregnancy-related eating disorder may benefit from a different level of care, and those care levels may change throughout pregnancy, childbirth, and parenthood. 

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Inpatient

Inpatient care involves 24-hour care at a hospital or treatment center. If a person is experiencing life-threatening complications during pregnancy or childbirth, a medical professional may suggest inpatient treatment. Inpatient treatment provides care to the mother and child during pregnancy to ensure proper health and development. 

Residential

Residential care is 24-hour care in a home-like environment instead of a hospital. Some people may undergo residential care if they benefit from daily assistance during pregnancy or parenthood but want more flexibility in their daily routine. 

Partial hospitalization program (PHP)

Partial hospitalization programs (PHP) blend inpatient and outpatient treatments. If a mother-to-be lives with a pregnancy-related eating disorder that has led to complications needing part-time medical attention, a doctor may suggest PHP. The mother-to-be would spend some days receiving care at a hospital or treatment center and other days at home. 

Intensive outpatient (IOP)

Intensive outpatient treatment (IOP) is an option for individuals who want to live at home and benefit from more structured daily care. Someone with a pregnancy-related eating disorder who gets IOP treatment may have to make daily trips to a doctor's office or complete regular check-ins with a therapist. 

Outpatient

Outpatient treatment means the individual lives at home and participates in their usual routine but receives treatment with less frequency, usually regular therapy on a weekly basis. Many individuals choose to continue outpatient therapy throughout parenthood to help them feel comfortable in their bodies after childbirth. Outpatient treatment can last anywhere from a few weeks to years. Some people may even choose to continue outpatient therapy indefinitely.

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Psychotherapy for pregnancy-related eating disorders

Many people living with a pregnancy-related eating disorder have found psychotherapy, or talk therapy, beneficial in their healing processes. There are various types of psychotherapy available, and doctors may suggest more than one as part of a treatment plan. 

Acceptance and commitment therapy (ACT)

Pregnancy comes with many physical changes to the body. Acceptance and commitment therapy (ACT) is about helping mothers-to-be accept the changes they experience during pregnancy and childbirth and the emotions that come with it. Once they can accept the changes, they can commit to change for the health and safety of themselves and their child. 

Cognitive-behavioral therapy (CBT)

Cognitive-behavioral therapy (CBT) helps individuals understand their eating behaviors so they can take action to make changes. Someone with a pregnancy-related eating disorder can learn the underlying triggers for their eating behavior. They may find their eating disorder results from a lack of control over their changing body or a compulsive nature to regulate what they eat. Once they start to understand their eating behaviors, they can implement change. 

Cognitive remediation therapy (CRT)

Cognitive remediation therapy (CRT) treats eating disorders involving signs of anorexia nervosa, including food restriction. (3) CRT works to build self-awareness in pregnancy-related eating disorders to understand how food restrictions affect pregnancy and the unborn child. 

Dialectical behavior therapy (DBT)

Dialectical behavior therapy (DBT) is about building interpersonal skills and regulating emotions. Pregnancy takes an emotional and physical toll on women. If a mother-to-be has a pregnancy-related eating disorder, the pregnancy can feel like an additional obstacle in managing one's emotions. DBT can help mothers-to-be process the changes they're undergoing so they can make informed decisions about their eating behaviors. 

Exposure therapy

Exposure therapy is a treatment option for those living with anorexia nervosa. (2) Anorexia nervosa involves food restriction, often because the individual has a fear or anxiety around gaining weight. If a mother-to-be struggled with anorexia nervosa before pregnancy and continues to restrict food while pregnant, they may benefit from exposure therapy. Exposure therapy encourages the mother-to-be to eat foods that trigger them to see that eating and potentially gaining weight is essential for the healthy development of their unborn child. 

Family therapy

Family therapy is group therapy involving the family during sessions. In the case of pregnancy-related eating disorders, the family unit tends to include the individual with the eating disorder and their immediate family, including the parent of the unborn child. Family therapy aims to help relatives understand their loved one's eating disorder and help them communicate with their family. 

Group therapy

Eating disorders can make people feel isolated and like they're alone in their struggles. Group therapy is a way to bring people with similar eating disorders together to learn from each other's struggles and successes. Group therapy can provide insight into dealing with inevitable body changes that come with pregnancy and the transition into motherhood for mothers-to-be. 

Interpersonal psychotherapy (IPT)

Living with an eating disorder can make people feel alone in their struggles, especially if they feel guilty or ashamed of their eating behaviors. Those with a pregnancy-related eating disorder may feel an additional level of shame because they may feel they're harming their unborn child. Interpersonal psychotherapy (IPT) helps mothers-to-be develop healthy relationships, including building relationships with their children.

Nutrition counseling and meal support

Proper nutrition is vital for the development of a child during pregnancy. Pregnant women require different amounts of nutrients, such as iron, calcium, and vitamin D. (4) Through nutrition counseling and meal support, a registered dietitian may educate mothers-to-be with an eating disorder on what they and their child need to develop and function properly. The dietitian needs to understand the mental and emotional challenges the individual may face to approach nutrition and eating behaviors in an empathic way.

Experiential treatments for pregnancy-related eating disorders 

Experiential treatments may benefit those living with a pregnancy-related eating disorder. Some individuals start art therapy to express their emotions and share how they perceive their physical self, especially as their body undergoes changes during pregnancy. Others may find help in instructive cooking, which are educational cooking classes focused on getting individuals to see food as more than a calorie number.

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Treating pregnancy-related eating disorders at Within Health

Within Health provides a revolutionary way for mothers-to-be to receive professional care for a pregnancy-related eating disorder at home. The experts at Within Health know each person has a unique healing journey and does not follow formulaic treatment. Instead, they personalize each person's treatment to meet the needs of the individual. 

Within Health offers PHP, IOP, and OP treatment that promotes inclusivity no matter the individual's shape, size, ethnicity, gender expression, sexuality, or background. Call our team today to start the journey to recovery.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Resources

  1. Within health: All about pregnancy-related eating disorders. Within Health | All About. (n.d.). Retrieved December 31, 2021, from https://withinhealth.com/ed/pregnancy-related-eating-disorders-pregorexia
  2. Steinglass, J., Sysko, R., Schebendach, J., Broft, A., Strober, M., Walsh, B. (2007). The application of exposure therapy and D-cycloserine to the treatment of anorexia nervosa: A preliminary trial. Journal of Psychiatric Practice, 13(4), 238–245. https://doi.org/10.1097/01.pra.0000281484.89075.a8
  3. Tchanturia, K., Lounes, N., & Holttum, S. (2014). Cognitive remediation in anorexia nervosa and related conditions: A systematic review. European Eating Disorders Review, 22(6), 454–462. https://doi.org/10.1002/erv.2326
  4. U.S. National Library of Medicine. (2021, September 8). Pregnancy and nutrition. MedlinePlus. Retrieved December 31, 2021, from https://medlineplus.gov/pregnancyandnutrition.html

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