I remember when I first realized that the amount of weight I gained in pregnancy was the same amount of weight that I had gained in my recovery from my eating disorder 15 years ago. It was a stunning realization that helped bring compassion to the parts of me that were struggling with pregnancy weight gain. Just like in early recovery, gaining weight and not feeling in control of the size of my body was emotionally distressing. When I was pregnant, people would frequently say to me “You look radiant!” And I thought “F*ck you I feel like a walking hippo-whale!” However, after 14 years of recovery, I had developed enough skills to be able to graciously receive compliments without restricting/avoiding them (anorexia) or deflecting/throwing them up (bulimia). I also realized, as I often tell my clients, fat (and feeling like a hippo-whale) is not a feeling.
FAT is not a feeling
For someone recovering from an eating disorder, “fat” masks underlying feelings such as fear, anger, grief, shame, vulnerability, and insecurity. As I approached the threshold of becoming a Mom, feelings of uncertainty, vulnerability, fear, and insecurity were big (aka fat). In fact, many of my fears, such as how to maintain a separate, autonomous, differentiated identity from my own mother that I had worked so hard at for so many years to develop in my recovery, as well as how to juggle the many hats of career, wife, and new Mom were quite real and quite visceral. Feelings of shame under the judgment that “I really should be over this body image thing by now” were also there. I remember, when doing my doctoral research on body image, reflecting on why there is not more research on body image: under body image there are layers of shame. Who would want to dig into that?
Shame is not an emotion that people turn toward with welcoming joy. Reflecting on shame, and how the secrecy of body image shame affects women considering having children, Claire Mysko and Magali Amadei discovered:
78% of women we surveyed who do not have children yet or do not plan to have children told us they have concerns about how pregnancy and motherhood could change their bodies. Most of them keep these concerns to themselves. 57% said they don’t talk about the connections among pregnancy, motherhood ,and body image with their friends. 51% said they never discuss it with their partners…And 79% of the women who have body fears related to motherhood name weight (getting bigger during pregnancy and not being able to lose the weight after delivery) as their number-one fear. 
Before becoming pregnant, I naively assumed, like most non-mothers, that the weight you gain in pregnancy is the weight of the actual baby. I thought “No problem, I’ll just gain (fill in appropriate amount for newborn baby here. I am deliberately not naming any weight numbers in this article to avoid any negative comparison triggers for women in recovery) and then, after the baby is born, I will lose that weight with the baby coming out!” Well, being pregnant I realized that the baby needs not only a womb-home with amniotic fluid and placenta within which to eat and grow, but also increases in Mama’s blood, fluids, nutrient/fat stores, and breast tissue. After the baby is born, much of that weight is still there.
Most women still look pregnant, albeit not 9 months, after giving birth. When I first heard that, the negative body image part of me said “Well then I’m not leaving the house until I don’t look pregnant anymore.” (Again, thankfully, I had 14 years of combating this negative body image voice and was able to talk back to it. I was also, frankly, too tired to care much about what I looked like postpartum. I put on sweat pants with a pony tail and that was good enough! In addition, I had a loving partner, recovery support system, family, and doulas surrounding me with love and cheering me on as I left the house post-partum!)
In my work with women recovering from eating disorders and negative body image, it is interesting to notice what parts of their bodies women tend to dislike the most. It is often their stomach, breasts, thighs, and butts. These are the areas that gain weight in becoming pregnant and a mother. Anyone that has ever looked at an image of the Venus de Willendorf, a goddess statue estimated to have been made between 22,000 and 24,000 BC near Willendorf, Austria,and thought she was fat would do well to look at a pregnant woman’s body. I would venture to guess, in no uncertain terms, that Goddess is pregnant! And her fertility, the parts of her body that celebrate her womanhood and the mysterious power to grow a child and feed that baby from her own flesh, is being gloriously celebrated.
What has happened to a culture that denigrates this power in a woman’s body to the point of glamorizing anorexic models, airbrushing the fat out of images of womans’ bodies, and glorifying actresses that lose the baby weight within weeks of having a child? The media images we are surrounded with not only do not accurately portray the reality of womens’ bodies in all their varying shapes, sizes, skin tones, and degrees of wrinkles, but the reality of women’s full ranges of emotions, life-roles, and challenges of the new identity of motherhood. Mysko and Amadei reflect:
There are plenty of red carpet “postbaby body” debuts mere weeks after celebrities give birth but we don’t see a lot of new moms’ bodies in the real world- mainly because most new moms are recovering at home, trying to juggle poopy diapers, feedings, pain, sleep, and the decoding of various baby-screaming pitches- all in a semi zombified state. (Amadei, 2009)
A Larger Identity
Just like recovery, becoming a Mom requires developing a larger and different identity. It also requires literally having a different body, one that was formed to feed and nourish a child from stores of fat. Along the way of becoming a Mom there are many opportunities to cultivate tolerating the distress of being in the ambiguity of the unknown. In the very beginning of my eating disorder recovery, I often felt like “this is too big- I can’t do this- I wish it were just about the food and being ‘fat’.” Sitting with the discomfort of feelings, many of them unpleasant ones, was not fun. There is a slogan in 12 step programs called “HALT,” which stands for Don’t get too Hungry, Angry, Lonely or Tired. This is hard to do in early recovery, and as a new Mom, it is almost impossible. Sleep deprivation, coping with a newborn wailing baby, and breast feeding/being postpartum hormonal flux create an atmosphere ripe with HALTs! My postpartum recovery slogan became, instead of HALT, accepting “This is hard.” Creating an atmosphere within my mind of radical acceptance made it easier to relax into the difficulties of new Mommy growing pains. And, just like recovery, I was challenged to lower my expectations of what is “good enough.” The perfectionistic, overachieving, self-critical temperament that served me in my eating disorder did not serve me in recovery and did not serve me in new Mommy-hood. I had to lower the bar on my expectations, again and again. One of my colleagues, a highly accomplished Therapist, Classical musician, and Horse dressage teacher gave me the postpartum advice to “do one SMALL thing each day and that is it.” For example, one load of laundry, take a shower, walk around the block with the stroller. Before having a baby I thought “Well that’s certainly not that ambitious. I can do much more than that.” I had also heard other mothers say how difficult it was to take a shower after having a baby. Again, I thought, “Wow, they must be pretty low functioning. Really, what could be that difficult about taking a shower? Just put the baby in a bassinet!” After having a baby, I felt very, very grateful for the awareness that others had had difficulty taking a shower and doing one small thing a day.
I have heard the metaphor that getting into recovery requires getting down on your knees in order to crawl through a very small doorway (humility of letting go of your old identity). However, once you are inside, you arrive in a spacious cathedral (your new right-sized larger self). I have found this to be true in motherhood as well. And actually, just like recovery, it really doesn’t have anything to do with the size of your body. It has to do with learning to tolerate uncomfortable emotions not only in yourself, as you become a brand new Mama, but in your baby as well! Recovery is about embracing a full range of emotions.  And, as anyone who has spent any time with a baby, so is parenting! As you become a “good enough Mother” to yourself, your baby will internalize how to do this as well.
Linda Shanti McCabe is a Mommy and a Licensed Clinical Psychologist. She works at the Association of Professionals Treating Eating Disorders in San Francisco. To read more about her work professionally, go to http://www.drlindashanti.com
 Mysko, Clair and Amadei, Magali, Does This Pregnancy Make Me Look Fat? Deerfield Beach: Health Communications, 2009.
 Poor sleep quality and lack of sleep are risk factors for Postpartum depression (PPD), a serious condition that negatively affects both mother and child. For more information on this link between sleep and PPD, see Massachusetts General Hospital website at: http://www.womensmentalhealth.org/posts/postpartum-depression-and-poor-sleep-quality-occur-together/
Postpartum depression (PPD) affects approximately 15% of women, usually occurs in the first 12 months after baby is born, and is different from “the baby blues,” which affect most women in the first three weeks postpartum. http://www.Postpartumprogress.com is a helpful website for information on PPD. If you think you may be at risk for or have PPD, see your healthcare provider.