The months immediately after childbirth (which are known as the postpartum period) can pose quite a challenge to new moms who have recovered from anorexia or bulimia. Heightened concerns about food and weight are not uncommon during this time. Sybil took care of herself and stayed healthy. So do the large majority of other new moms with histories of eating disorders.

This doesn’t mean it’s easy. Sybil describes the turmoil she experienced during her first months of motherhood: “After Suzanne was born, my belly and thighs seemed flabby. Looking in the mirror made me feel that I did not deserve to exist. As far as I was concerned, I needed to lose weight quickly. At first, I aimed for my prepregnancy weight, or at least that’s the impression I tried to give Darren, my parents, and even my doctors. ‘After all,’ I asked them, ‘don’t most women want to lose the pounds they gained during pregnancy?’ I signed up for an exercise class for new moms, but it only met once a week, and I figured that I had to be much more active than that if I hoped to get rid of my flab. I tried to calculate the amount of physical activity I’d have to get each day to make the pounds melt away.

“With taking care of Suzanne, finding the time and energy for my exercise regime was easier said than done. And there was another problem. I’d always structured my days carefully so that I knew ahead of time what I’d be doing when. I had a set time each week for doing laundry and a block of time every day for working on grad school assignments. I’d been particularly strict about my exercise schedule, allowing no interruptions whatsoever. Now that I had a baby, it was difficult enough to fit in the amount of physical activity I demanded of myself; what made it harder was the fact that I couldn’t plan my workouts in advance but had to exercise on the spur of the moment, if and when time allowed.

When Suzanne needed me, she needed me intensely, and as much as I loved her, taking care of her made my days less predictable than they had ever been. Interferences with my exercise program sometimes drove me to the point of panic. And when I perceived that I wasn’t meeting my physical activity ‘obligations,’ my fears of weight gain skyrocketed to the point that I’d have an urge to reduce my food intake.”

Some new moms who have had eating disorders need closer professional monitoring than others during the months following childbirth. Sybil tried to lose weight more quickly than was advisable and needed help understanding that this tendency can increase the likelihood of binge eating and purging. A minority of new moms-whether or not they have abnormal eating behaviors-develop postpartum depression, which is sometimes related to body image concerns. For those who experience postpartum depression, professional help is available and can make a world of difference.

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David B. Herzog, M.D., Debra L. Franko, Ph.D., Pat Cable, RN

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David B. Herzog, M.D., is the Harvard Medical School Endowed Professor of psychiatry in the field of eating disorders at Massachusetts General Hospital and the director of the Harris Center at Massachusetts General Hospital.
Debra L. Franko, Ph.D., is a professor in the Department of Counseling and Applied Educational Psychology at Northeastern University and the associate director of the Harris Center at Massachusetts General Hospital
Pat Cable, RN, is the director of publications at the Harris Center.