Most eating disorders, including binge eating disorder, food addiction and emotional eating occur in women during their reproductive years. It’s not unusual for someone with an eating disorder to also be pregnant or for relapse of an eating disorder to occur during or after a pregnancy. My guest will discuss some of the issues related to nutrition that occur when eating disorder like binge eating disorder, food addiction and emotional eating occur in pregnancy.
In this podcast, you will learn:
1. What is the most critical time for your baby to get the best nutrition for health and development?
2. What are some of the triggers during pregnancy for binge eating disorder, emotional eating and food addiction?
3. How to nourish yourself during the fourth trimester.
Mentioned on the Show:
If you’re interested in learning more about food addiction, enter the book sweepstakes to win a copy of The Food Addiction Recovery Workbook.
Schedule a free consult to discuss your food and body image issues: https://findingyouranchor.as.me/CONSULT
To learn more about The Anchor Program a 12-week non-diet program offering ONLINE group and individual sessions for the treatment of binge eating, emotional eating, food addiction and compulsive overeating. Want to learn more about the Anchor Program? https://AnchorProgram.com
Jaren Soloff is a Registered Dietitian and International Board Certified Lactation Consultant (IBCLC) who serves as an expert in women’s health. While continuing to practice in the field of eating disorder treatment, Jaren gained additional experience as an IBCLC to fuse her love of nutrition and women’s health. Now working solely in private practice, Jaren combines her expertise as a skilled nutrition therapist and lactation consultant to support mothers in nourishing themselves and their babies with confidence. FULL CRCL provides nutrition counseling and lactation consultations to help both mom and baby thrive in motherhood. Informed by her own journey and the hundreds of women she has counseled, Jaren’s experience comes full circle to support women in navigating pregnancy, birth and postpartum from a simple and intuitive framework.
You can reach Jaren Soloff, RD and find out about her book at: https://www.fullcrcl.co/about
Welcome to the Dr. Carolyn Coker Ross Show. It’s me, Dr. Carolyn. And today I have a special guest who is going to be talking to us about nutrition in pregnancy and how pregnancy can affect your disordered eating as well as if you have an eating disorder and you become pregnant. So she’s going to give us some good advice about how to manage that. And also talk a little bit about lactation, which isn’t a usual topic that we hear on podcasts, but I think it’s a very important topic. So stay tuned.
Dr. Carolyn: Hi, everyone and welcome to the show. Today I have a special guest with me. Her name is Jaren Soloff, and she is a registered dietician and international board certified lactation consultant, who serves as an expert in women’s health. While continuing to practice in the field of eating disorder treatment, Jaren gained additional experience as an international board certified lactation consultant to fuse her love of nutrition and women’s health. Now she works in private practice and combines her expertise as a nutrition therapist and lactation consultant to support mothers in nourishing themselves and their babies with competence. Full circle provides nutrition, counseling, lactation consultations to help both mom and baby thrive in motherhood informed by her own journey and the hundreds of women she has counseled Jaren’s experience comes full circle to support women in navigating pregnancy birth and postpartum from a simple and intuitive framework. Welcome to the show Jaren.
Jaren: Thank you so much for having me.
Dr. Carolyn: You know, I don’t think this topic is something that we usually talk about a lot in terms of eating disorders and yet eating disorders coincide with a woman’s reproductive years. So it is a really important topic and there may be people listening, who’s eating disorder, you know, got worse after pregnancy or, you know, they relapsed during pregnancy or after et cetera. So I wanted to start by just talking generally about what the role is in nutrition, both before someone conceives, during pregnancy and then in the postpartum era. Cause I know, you know, I speak a lot on neurobiology and I know brain development is severely impacted by nutritional intake even before you get pregnant. So can you give us just a little brief nutrition in pregnancy one 101 talk?
Jaren: Absolutely. I could talk about this stuff in my sleep. So the preconception time is really kind of that time where we’re setting the framework and the base for the pregnancy and even the parents’ postpartum experience and their ability to heal from birth. So some of the basics that really come to mind for anyone entering each of that phase is, you know, making sure that your nutrition and your stores overall are adequate. So certainly in the context of an eating disorder, but just generally it would be, you know, making sure that you’re having a good combination of different macronutrients and micronutrients. We talk a lot about full late specifically for women of childbearing years, just because it has such an impact on the early few weeks of a pregnancy. So the recommendation is typically that if you are in those childbearing years to have some kind of full supplement throughout that time, and of course you can get it through your diet as well, but we’re really focusing on the first year before pregnancy and planning them that you’re getting a wide variety of foods and, uh, you know, amount of nutrients from preferably a whole foods diet, and then some supplementation if needed as well.
Dr. Carolyn: Are there any, any ways in which poor nutrition can increase the child’s risk for an eating disorder after, you know, as they grow
Jaren: Interesting. So I think of what’s coming to mind is undernutrition and irregular erratic, you know, nutrition. And that might show up if the parent has an eating disorder. I think we more so see it in patterns of pregnancy in terms of low birth weight or preterm delivery. Um, sometimes the parent’s healing postpartum can be impacted if there’ve been eating disorder behaviors. Um, but in terms of specific nutrients, I’m thinking of more, so the overall pattern of nutrition and health that can really get corrected.
Dr. Carolyn: Sure. So how do you prepare, let’s shift to talking about a woman who either has an eating disorder or has a history of an eating disorder? What are the kinds of things that you would, uh, be looking out for, or that you commonly see when they become pregnant?
Jaren: So pregnancy is a time I think, throughout any woman’s life where, you know, if you have a history of an eating disorder or if you are still struggling in some way, it can feel really intense with the amount of triggers. There’s a lot of awareness around nutrition. Um, we think about, you know, trimester by trimester there’s conversations around, you know, what you should be eating, what you shouldn’t be eating, which is intended to be supportive to help the fetus and your baby grow. But when you’re in recovery, those can feel, um, very intense. So there’s also a lot of focus on weight gain during that time. And we hear, you know, specific numbers around ranges, which again are intended to be helpful, but depending on your history, um, you know, of where your weight and nutrition have been prior, that can also be, you know, a point of intensity and a trigger as well. So some of the things to kind of look out for are really noticing some urges or changes in food behavior, appetite might change as well. Um, hormones are changing during that time and that can affect mood and appetite together. There might be changes in your relationship during that time as well, because it’s a, a huge life change. Um, so there can be a lot of vulnerabilities that we know can trigger the reoccurrence of eating disorder behaviors during that time.
Dr. Carolyn: Right. I also think about body image because in pregnancy, there are so many changes in a woman’s body. And I think that can be very triggering to a woman who has body image issues. Do you see that as well?
Jaren: Absolutely. And I often see it, you know, not only during the pregnancy, but this is something that if an individual is contemplating growing their family and knowing that pregnancy is a time where you are going to have to experience weight gain, and that can feel so tricky because that’s a really common fear and eating disorders and through recovery that, you know, your body is going to change and your weight’s going to shift as part of that.
Dr. Carolyn: What about women living in larger bodies? And when they get pregnant, are doctors recommending again, more weight loss, or how is that, how do you handle that?
Jaren: It’s so tricky, but it’s a really great conversation because there’s a lot of weight stigma in the fertility and the pregnancy space. So the kind of standard medical recommendation is that, you know, individuals may use the BMI, which we know is not a great marker at all for measuring someone’s health, but they use someone’s BMI to determine how much “weight they should gain”, um, throughout the pregnancy. So individuals who live in larger bodies are expected to not gain as much during a, which
Dr. Carolyn: It seems a little bit unfair because you’re saying you have to be on a diet, you know, the worst thing in the world, in some cases, and then to the person who’s at the other end of the spectrum, you’re saying you have to do the hardest thing that’s for you, which is to gain weight. So that’s a tough, it’s a tough time if you are pregnant and you have an eating disorder.
Jaren: Absolutely. And depending on, you know, unfortunately we know that it’s pretty uncommon to have, you know, some medical providers that are going to be understanding of the unique circumstances of having a history of an eating disorder and what that might mean for you during pregnancy and having these conversations around weight.
Dr. Carolyn: Yeah and I would think that those, some of those conversations to actually may trigger relapse so that, you know, someone with anorexia may start to restrict or have the urge to restrict and, you know, someone who’s maybe has binge eating disorder, uh, may have the urge to binge with those kinds of conversations. It’s kind of like chicken, egg kind of thing. You know, if you don’t have the conversations, then I, you know, I know patients are always thinking about their bodies and what they’re eating and should they be gaining weight or losing weight, all of that stuff. And I don’t know, how do you navigate that as a, you know, as a dietician, to keep it from being a triggering conversation?
Jaen: Well, you know, ideally, or these clients are working as individuals are working with a treatment team, if they’re noticing that these urges or these symptoms are starting to intensify or reoccur, and that might include, you know, taking blind weights at their physicians or their midwife’s office, you know, doing different measurements in terms of growth and development for the growing fetus during that time. So there’s some different ways that we can be mindful of someone’s experience as they go throughout the pregnancy that don’t include focusing on weight.
Dr. Carolyn: Good. Yeah. That’s excellent. Um, what about perinatal mental health and nutrition? How do you conceptualize what needs to be done there?
Jaren: Oh, it’s huge. And I think it’s a piece of our field that I’m hoping will continue to grow and expand. I think we’re just now tapping into understanding more about postpartum mood and anxiety disorders, and we’re bringing a lot of awareness, but we’re also finding some literature and research to show that, you know, someone who has experiences of postpartum mood and anxiety disorders, who also might be in eating disorder recovery is going to be more at risk for a relapse during postpartum, which makes a lot of sense. I think to us as providers when we’re doing this work, you know, day in and day out. Um, but I think we still have not gotten the message to understand that postpartum is actually a very vulnerable time for someone to be at risk of a relapse. So we think about how we educate our clients on, you know, okay, here are the times in your life, a big transition or big stressors that can be high risk times for relapse. Um, postpartum is one of them, there are huge hormone shifts. There are, it’s a huge just life change overall, your body is depleted of nutrition and there can be a lot of mood shifts that occur in response to some of the hormonal changes or the birth story that happened as well.
Dr. Carolyn: Yeah. Cause a lot of people get their expectations up that they can’t control, you know, what happens during the birth and that, you know, it’s kind of one of those best laid plans, you know, often go awry because it doesn’t always go as they, they feel it should. And postpartum depression, especially for an older mother is, is an issue too. Is that something you see a lot of?
Jaren: I think we are seeing just more identification of postpartum depression overall, but certainly when there’s, and there’s several different risk factors, but even thinking about, you know, retrospectively I think a lot of us might think now like, Oh, I was probably experiencing postpartum depression. I didn’t even know it because we weren’t talking about it. I didn’t know how to identify it at that time. So yes, I think we’re understanding and recognizing a lot more of it.
Dr. Carolyn: What do you recommend for patients who’ve had eating disorders who are struggling with fertility issues, those nutrition have a role to play in that?
Jaren: Absolutely a huge role. And again, it’s a such a tricky balance because you know, many individuals who are struggling with fertility are introduced to a large body of information around nutrition and fertility. And often that can have a lot to do with weight. I can be very saturated in diet culture, but if someone is specifically in recovery from an eating disorder, we know that there can be, you know, a amenorrhea that might be impacting fertility. And so, you know, weight gain or weight restoration could be part of that process.
Dr. Carolyn: It’s when someone loses their period because they may have anorexia or bulemia yeah.
Jaren: Yup. Hyperbolic can’t talk H A amenorrhea, um, is this like female athlete triad, but you know, not having a regular menstrual cycle because of inadequate nutrition or overexercise, so nutrition can play a huge role in terms of getting more restored in terms of weights or nutrition. Outside of that, we know that infertility is now impacting one in eight women. So it’s, it’s becoming more prevalent overall and some of the nutrition strategies might include working towards a more anti-inflammatory diet and style of eating, which, you know, kind of models of Mediterranean style of eating. So, you know, complex carbohydrates, lots of, you know, more on saturated fats, variety of different protein foods. Um, and of course, you know, flexibility and variety.
Dr. Carolyn: Good. Well, what is the most difficult client that you find to work with and like, to also include in another question about the lactation experience in women with eating disorders. So you can pick which one you answer first.
Jaren: A difficult client. I mean, I feel that it almost has like a negative connotation, which I don’t think you’re intending. I really do feel it’s so complicated for individuals that are navigating in fertility and eating a disorder recovery. And it’s because I think both of those experiences individually are so impactful on a personal level. Right. Um, and to have the complexity of being an eating disorder recovery, and also have so many unknowns of infertility can just be really heart-wrenching. So I have a lot of compassion for individuals that are in that space.
Dr. Carolyn: Okay. And then what’s the lactation consulting experience like with women with eating disorders does, again, that touches on the body image piece, you know?
Jaren: Yes, it can, because during lactation, there can be, there can be weight preservation and energy storage that the body is trying to turn and move towards in terms of adaptation and trying to protect and make sure that the mom has adequate stores for the baby. So this is, you know, one of the big kind of conversations of postpartum is a lot of individuals are really concerned with weight loss or getting their body back, feeling like themselves. And so there’s a lot of these messages that, you know, our body is really trying to protect us during that time to make sure that our babies can be fed and that might result in weight being retained during that time. So that can be a challenge. There can also be challenges just with the feeding relationship between mom and baby. Um, Oh, there’s a lot of messages around, you know, thinking that we have to have perfect diets as mothers in order to breastfeed. And if we have a history of black and white thinking, um, our complicated relationship with food that can feel very intense and triggering, um, for wanting to try to breastfeed our baby. And the last one that I’m thinking of that I see really commonly in the lactation world is there’s a lot of conversations around infant food allergies or intolerances now. Um, and so, uh, pediatricians are often very liberal with, you know, having moms do diets, eliminating dairy, eliminating certain types of foods. And you can imagine, you know, for someone in recovery that that can be, you know, very sensitive because the mom has to restrict her diet. And it’s usually not indicated it’s usually actually very uncommon for babies to have a true allergy to something in mom’s diet, that’s being passed through her milk.
Dr. Carolyn: So it’s not uncommon for babies who are eating real food to have some food allergies, but you’re saying it’s, they’re just on breast milk. It’s unlikely that what the mother’s eating is going to cause a food sensitivity that’s right. Cause it’s, nature’s perfect food. Right.
Jaren: Right. Our bodies are, they’re incredible. And you know, the level to which it passes from a mom’s diet to the baby is very, very small.
Dr. Carolyn: Yeah. Good. Is there any, anything else that I haven’t asked you about that you’d like to mention before we end the podcast?
Jaren: I think I hope I just reiterated, you know, that if someone is in eating disorder recovery, or, you know, even if they don’t have that experience, I’ve had many individuals come to me that because of their experience throughout pregnancy and postpartum actually prompted, um, the star of disordered eating or a complicated relationship with food. And I think it can feel really surprising. Um, but again, you know, trying to build in the language that actually this time period is extremely vulnerable. When you think about all the layers, it makes a lot of sense that, you know, it might trigger, um, disordered eating or eating disorder. So really just highlighting that, that this is a really vulnerable time.
Dr. Carolyn: And I think also important to get help if you are struggling because it’s so important. And it’s not necessarily something that we’re taught, like what we need to eat to make our babies healthy. So get being able, being willing to get help with the dietician like yourself, I think could be very useful for most of us. And especially for someone who’s in recovery from an eating disorder.
Dr. Carolyn: Thank you again for being on the podcast and I will be putting your contact information in the show notes so people can contact you if they like to follow up. And I appreciate all your wisdom and knowledge.
Jaren: Thank you for having me
Thanks for listening to the podcast. I wanted to mention that Jaren Soloff, who we just had as a guest does have a cookbook it’s called the Post Natal Cookbook, simple and nutritious recipes to nourish your body and spirit during the fourth trimester. So she does offer five free lactation boosting recipes from her cookbook, which you can access on her website. And I’ve posted a link to the website in the show notes. So I hope that this was helpful for you. And if you are a woman who’s pregnant and has a history of an eating disorder that you will get help if you’re struggling. Thanks for listening. This is Dr. Carolyn signing off