DH + Pregnancy & Anorexia

[DH2R]

My DW (do you use DW for the counterpart to DH? am new!) has anorexia and is also ~6 months pregnant.

We live together away from both of our families and so have little in the way of a support network.

I have experienced anorexia before in the past when my sister suffered, and at the time I learned that the best way with her to deal with it was to completely butt out of any conversations about what she ate. Until now I've, on the whole, done the same with DW.

All tests of blood and scans of baby so far have showed no problems whatsoever. Medical professionals have all seemed happy with how things are going.

However... in the last few weeks DW's face has started to show the signs that I spot when her weight is dropping. Her temples and cheeks are a little more sunken than normal and she has quite a development of downy bum fluff on her jawline (which I know may all also be as a result of pregnancy).

She's actually upped her daily calorie intake from circa 1000-1200 before pregnancy, to 1300 to 1400 during it. And since I started to moan at her as a result of this recent facial change it has now gone up to ~1500.

She is ~5'4" and looks healthy when not pregnant when she's about 8.5 stone. When I punch these numbers into calorie intake calculators (there are a few on the net) it suggests she should have been on around 1900 before now, but now at 6 months gone should be on well over 2000.

I'm trying to convince her to up her intake - not an easy task with an anorexic. I keep saying to her that although it might be OK for baby at the level's she's eating it also might not and that there's no risk whatsoever if she was to up her intake. Obviously there is a risk with this to the anorexic mind - she might gain weight.

Result of this is that each time I approach the subject she becomes extremely (and I mean extremely) stressed about it. The anorexic mind comes to the fore and she turns nasty. It's a very jeckyl and hyde thing. This is extremely upsetting. I feel hated to the fullest extent and I have to work hard not to run away, curl up into a ball and cry, or lash out at the walls.

But if I don't say anything she will continue to eat around 1500 calories a day, which might perhaps be detrimental to the development of my unborn child. But then so might the stress that is casued every time I bring it up.

She eats fantastically healthily - fruit and veg aplenty - but is it enough?

I'm really struggling with this.

Nor is it comparable to alcoholism, not in most of the relevant aspects anyway

and I don't appreciate the word 'addict' being used in this context. I think that's unnecessary dramatism at the least

what do you propose this man does? Remove the child from its mother's care at the age of two? FGS

sorry but there are many people who struggle with illnesses that are extremely caring and good parents and would do anything to put their child first. it takes time for the sufferer to see and recognise all their behaviors that are not helpful to their health, and then be in a place to challenge and fight them, and to become free. its a process. noone is perfect! the OP's wife sounds she is doing what she can at this time for her and the baby - she has upped her calories a few times - you can't run before you can walk, she has made great progress and with encouragement may continue on this path until she has enough intake and perhaps get good support to keep it a habit. she does not need criticism right now.

I've posted my experience earlier but heres some things that my DH has done which has helped me eat more, may not work for your wife but worth a try :)

• we stashed up on 'safe' foods... so theres not been a time where ive been able to say theres nothing in the house I can eat/ or nothing I like in, so I had no excuse.
• Often if he offered me something I liked to eat and I refussed he would sit next to me and eat it, a lot of the time I would start eating bits of his!
• Hes also snacking loads with me ( as I find it easier to eat when others eat)

Hes made it look all really innocent (maybe it was?) I dont know but its helped me either way as hes made eating more less of a big deal.

Oh and Ive become more hungry in my last trimester, so hopefully the same will happen for your wife!

cherryjellybelly, your DH sounds amazing. Good luck with everything.

There are a few people on this thread who have no experience of this illness, most of their advice is complete BS, and it is fairly obvious to anyone who has. Panicking her, making her more anxious and stressed out than she is, will not help. It will likely make her feel even less worthwhile, and more of a failure, than she already feels. Like some others have said: she is trying, she is making progress, and the docs are not worried about baby's progress. Keep encouraging her to eat without being pushy, tell her you love her and support her.

Hi DH2R,

I have a 7 month old ds and was put under consultant care whilst pregnant as I have a history of AN and had a low BMI when I went for my booking appt. I really recommend you mention it to the midwife, no one is going to try and bully your wife but there are ways of helping her (maybe seeing a nutritionist) and your baby. I had growth scans throughout my pregnancy so that they could see how well he was developing and I ate as much as I could when I could (last trimester I couldn't face much but that was due to other physical things not AN).

The last thing I want is for ds to be affected by my issues with food and I am well on the way to recovery now and in an odd way I think that pregnancy helped by showing that even when you lose control of your body you still have control of your mind. I really hope you get the support you both need (carers suffer too) and that your wife can accept any help given to her as that's the hardest part IMO. Please talk to your midwife about this though!

DH2R Congratulations on baby!

Good on you for coming and asking and for being so concerened! I'd book an appointment with your wife's MW or at least her GP so they can flag it up with MW (GPs and MWs do very little sharing info from what I can tell), and share your concerns. There is no reason for MW to be checking weights for your wife unless your wife has disclosed the eating disorder or is over the BMI (the 2 usual reasons).

I think you've got to the point where your wife is not listening and has panicked herself into 'denial' (she knows, but may be unable to deal with it) that there may be an issue. Though, as others have said, she has come a long way to have increased her intake already.

The stress is bad for her, yes, but it needs to be addressed, for HER health - it sounds like she's feeling she's lost control and the weight-control/calorie counting is her way of coping, but I could be wrong! Yes, you stressing at her highlights this lack of control and no doubts she feels horribly responsible, but not tackling it means the issue isn't going to get any better - after all, she's fighting with a mental illness, and with a mental illness or not, we all need help and support at points.

I don't know if you've tried this tack with your wife, but instead of your concern being about weight/calories/directly about baby (although it is), talk about her worries and feelings - which untimatly you are concerned about, men tend to phrase it differently though. Even though food is used as a control for the emtotions, it's not the food that was the cause of the feelings, the food is a subsititue...thus asking about the food directly can 'miss the point'...

If she's anythig like me she's horribly overwhelmed by pg at points and probably just needs someone to share it with (sobbing on my teddy or one of my cats helps if DH isn't about)- especially if she's not got a network of friends round her (I've a history of severe depsression and a lack of control is a big issue for depressives too). She may not want to share with you, so as not to worry you, but point out you're already worried about her...so ask her to share with someone...and then at least you've tried that way of looking at it.

There may be no issue with issue at all with baby, as others have said, the buggers will take all they need! BUT, it's definitely worth raising with MW/GP as if it does become an issue, it's better it's spotted sooner rather than later.

For your own peace of mind, talk to her MW/GP, take wife along if you think it will help you both. At the moment you're in 'opposition' to eachother, which is distressing you both. She needs to see you're worried, but that you're ultimatly there for her (which you are, we know, and she does too). If you're MW/GPs any good, they will allow you to get out your concerns, talk through the facts and then present both of your with your options, or should direct you to someone that can.

Good luck, and keep us upadated.

The thing is OP that when she sees her baby belly she will panic into a dysmorphic cycle, and even though she knows she's pregnant, she will assume it's food related. Hence the dip in weight (hollow look) at about 6 months, when the baby bump starts to show - after that she will get hungrier and eat more, especially in the last month.
The last thing she needs is a 'clucky' husband who's watching her intake.
I'm feeling you really do need counselling about anorexia OP if your analysis is that 'she should eat more'. Of course she 'should' but that's so not the point.

Your DW will need so much help to find herself again and explore her feelings as a mother after the baby is born - please concentrate on that aspect of your lives as parents. You will need a weekly cleaner and at least three mornings / evenings help to look after the baby to give her time to grieve for her pre baby self, and accept herself as she is 'now'. She may well need some serious counselling too, with all this media blumph about 'regaining your pre baby' figure. These are expensive, so start saving to pay for them.

Let your DW do what she has to do in the meantime, and if the Drs and the MWs are happy, rejoice - so what she's not 'eating for two' and isn't looking like you think she should - her doc and MW are happy, if you're not, you need to explore that.

Start saving for help after the baby is born.

Again sorry to be so blunt about it.

Coming to this thread a little late but here goes. Anorexia nervosa is a biologically based brain disorder, not a lifestyle choice. It is not that your wife won't eat: she can't. This is not her fault. She did not choose it.

1,500 calories a day is a strict diet. The RDA is between 2,000 and 2,500. My deep concern is your wife's heart. When a body is starving it eats away at muscle mass and the heart is a muscle.

Information and understanding about eating disorders in the NHS system is not good. This is not their fault either (I'm not into blaming, can you tell?) as the training for doctors is one afternoon at med school. However, it is an increasing problem and a deadly one. 1 in ten anorexia nervosa sufferers die, either as a result of their starvation or as a result of complications arising from - ie a heart attack. The figures for Bulimia Nervosa and Binge Eating Disorder are higher - again the strain on the heart and potassium levels are key here. I am sorry to be so stark.

I would suggest two websites for help with nuturing your wife back to health www.feast-ed.org (a resource for parents and carers of anorexia patients) and www.eatingresearch.com (the Eating Disorders Unit at the Maudsley Hospital, London).

Good luck