I'm Scared of Gaining Too Much Pregnancy Weight

I'm 28 weeks pregnant and I have become consumed with the idea that I'm gaining too much weight. I think about how much I'm eating all the time, even though I'm on track for the right amount to gain.  To be honest, I have always thought a lot about my weight, and worried about getting fat, but this is a new level of obsession. I feel bad, like I am hurting my unborn baby by stressing out so much.  Sometimes I try to cut calories all day and then I'm starving at night so I binge on ice cream.  My husband thinks my behavior is strange but he would never believe it if he knew how often I think about food, weight, and mentally calculate the calories in what I eat. Am I truly crazy?

Dear MCTWA,
No, you're not crazy, but you do show signs of disordered eating. It's not just you, though.
Many women become obsessed with their weight, not only during pregnancy, but throughout their lives. Pregnancy is particularly difficult because there is no way to really diet, since you know doing so would harm the baby, and your body is changing rapidly, dramatically, and, many feel, pretty unattractively.  But honestly, women often feel like crap about their bodies a great percentage of the time, and engage in semi-disordered eating constantly.  What do I mean by semi-disordered? Well, here are the DSM criteria for anorexia:

• Refusal to maintain a body weight that is at or above the minimum normal weight for your age and height
• Intense fear of gaining weight or becoming fat, even though you're underweight
• Denying the seriousness of having a low body weight, or having a distorted image of your appearance or shape
• In women who've started having periods, the absence of a period for at least three consecutive menstrual cycles

You're saying, well, I'm a normal weight, I've obviously not anorexic. But if you leave out the criteria that have to do with weight and only focus on the ones that have to do with how you THINK about eating and your body image, do you fit the profile? You exhibit intense fear of gaining weight and I'm betting you have a disordered image of your shape (e.g., you think you look fatter than you do). The book Almost Anorexic: Is My (or My Loved One's) Relationship with Food a Problem? (The Almost Effect) talks about this issue in detail.  There are so many women (and, increasingly, men) who constantly count calories, feel bad about their bodies on a daily basis, have outsized fears of certain foods (e.g., pizza, ice cream), and who use the number on the scale as an indicator of whether they should feel okay about themselves that day or not. Just because you aren't below a certain weight, vomit up your food, or binge eat, it does not mean you don't have disordered eating.
Was your mother also very focused on being thin or not eating "bad" or high calorie foods? Often poor body image and eating issues are passed from generation to generation. Therefore, sadly, your  poor self-image in regards to your weight may be transmitted to your child, when he/she grows up and is old enough to realize that mommy is always worried about what she eats, or your child notices you looking in the mirror and frowning.  Even if you don't openly call yourself fat or talk about dieting, your child will pick up on the fact that you feel bad about yourself and that it has to do with eating.
However, the good news is that the cycle can end with you. If you focus on self-acceptance and focus on what your body can do (give birth, nurse, exercise, have sex, and so forth) rather than its measurements, this can be a start to changing your almost-eating disorder. A skilled therapist may be able to help you with this, because it is certainly not easy to change how you view your body and food. Read this guest post here about how the book Intuitive Eating changed someone's relationship with food for the better.
Good luck with this, and with your pregnancy.  Till we meet again, I remain, The Blogapist Who Tried to Eat 1000 Calories a Day For Three Months Before Prom And Didn't Think That Was A Problem At The Time.
This post was originally published here on Dr. Psych Mom. Follow Dr. Rodman on Dr. Psych Mom, Facebook, Twitter, and Pinterest. Order her book, How to Talk to Your Kids about Your Divorce: Healthy, Effective Communication Techniques for Your Changing Family.