Eating Disorders & Disordered Eating in the Perinatal Period
Conference Summary Report
This conference focused on supporting women with eating disorders during pregnancy and the perinatal period.
Pregnancy and Eating Disorder Recovery
Dr Laura Renshaw-Vuillier, a researcher and recovered eating disorder patient, shared her personal journey with bulimia nervosa and how pregnancy challenged her recovery. She discussed the complexities of managing eating disorder behaviors during pregnancy, including the relapse risk in the first trimester and the pressure to lose weight postpartum. Laura emphasized the need for early self-support, body acceptance, and continued postnatal care, highlighting the importance of paternal support and the potential for genetic transmission of eating disorders to children.
Perinatal Eating Disorder Support Strategies
Laura shared her personal experience with the NHS weighing program and its impact on her daughter, highlighting how it can be triggering for parents with eating disorders. She emphasized the importance of challenging societal norms around body image and weight, particularly for children. Laura also discussed her journey to recovery and the challenges of navigating these issues as a parent. The session then transitioned to a presentation by Dr Catharine Clark and Olayemi Adeniran, Psychological Therapists at South London and Maudsley NHS Foundation Trust, who discussed the practicalities of supporting individuals with eating disorders during the perinatal period. They covered topics such as risk management, safeguarding, and the use of blind weighing as a tool for monitoring weight gain during pregnancy. The speakers also touched on the importance of psychoeducational tools in normalizing weight gain and addressing distorted expectations about body changes during pregnancy.
Pregnancy and Postpartum Eating Disorder Support
The discussion focused on providing psychoeducation about normal pregnancy changes, emphasizing that weight gain reflects foetal growth and is necessary. They highlighted the importance of dietetic support in pregnancy, including managing cravings, nausea, and constipation, while avoiding restrictive eating. Postpartum, they addressed challenges around breastfeeding, including body image concerns and the need for adequate nutrition. They emphasized the importance of flexible, compassionate support and practical strategies like maintaining regular meals, having accessible snacks, and using CBT tools to manage eating disorder symptoms during this vulnerable period.
Pregnancy Eating Disorders Support Challenges
Catharine discussed the challenges and opportunities for supporting women with eating disorders during pregnancy and postpartum. She highlighted the importance of capitalizing on high motivation during pregnancy while encouraging self-compassionate recovery, and the need for close assessment and tailored support, considering the high demand and potential need for intensive interventions postpartum. She also stressed the importance of joint working between eating disorder and perinatal teams, including monthly meetings and collaboration with midwives and other professionals. The discussion covered various risks and considerations, such as physical and mental health, bonding, and feeding challenges, with a case study illustrating these complexities.
Perinatal Eating Disorders Partnership
Catherine and Olayemi shared their experience of creating a joint working group between perinatal and eating disorder services. They described how they established regular meetings with clear terms of reference, invited relevant staff, and developed a structured agenda that includes quick updates followed by case discussions.
Hope Virgo, an author and international award-winning campaigner for people with eating disorders, shared her personal experience of having an eating disorder during pregnancy. She discussed the challenges she faced, including the normalization of eating disorder culture during pregnancy, the lack of understanding and support from healthcare providers, and the pressure to meet societal expectations. Hope emphasized the importance of providing multidisciplinary support, reframing conversations around food and exercise, and offering emotional support to pregnant individuals with eating disorders. She also highlighted the need for better funding and resources for eating disorder services, as well as the importance of collaboration between campaigners, clinicians, and policymakers to improve care for this vulnerable group.
Pregnant with an Eating Disorder: Cultural and Societal pressures
Lottie Bolster, a neuroscientist turned artist and mental health advocate, shared her experience with eating disorders and pregnancy, highlighting the challenges of balancing recovery with the demands of motherhood. She discussed the cultural and societal pressures that contributed to her relapse during pregnancy and the importance of treatment that acknowledges these contextual factors. Lottie emphasized the need for flexible and personalized approaches to recovery, contrasting her positive experience with a therapist who considered her role as a mother with a previous treatment plan that did not account for her specific circumstances.
In-patient Treatment whilst Pregnant
Carly Shepherd, Senior Eating Disorder Clinician, Gloucestershire Health & Care NHS FT, shared her personal experience of living with an eating disorder while pregnant, highlighting the challenges she faced and the impact it had on her mental and physical health. She described her inpatient treatment, the lack of autonomy she felt, and the compassion she received from the nursing team, which helped her choose recovery. Carly emphasized the need for more training and understanding around eating disorders during pregnancy, as well as the importance of compassion-focused therapy. She also expressed a desire to have her daughter, now 18, speak about her perspective as a child of a parent with an eating disorder in the future.
Pregnancy and Eating Disorders Support
Cecilia Brundin Petterson, Research Student, Eating Disorders, Sweden presented her PhD research on the support needs of pregnant women with eating disorders, highlighting four main discourses: pregnancy as an end to the eating disorder, loss of control, pregnancy as a parenthesis, and pregnancy as a safe space. She discussed the lack of studies on this topic and the importance of person-centred care and the importance of listening to women's voices.
Compassion-Focused Therapy for Eating Disorders
Thomas Midgley, CBT & Compassion Focused Psychotherapist, presented on Compassion-Focused Therapy (CFT) and its application in treating eating disorders, particularly during pregnancy and postpartum periods. He explained CFT's three systems model and how it addresses shame, fear, and emotional regulation. Thomas shared a case study of a client who experienced improvements in her eating disorder and OCD symptoms through CFT, particularly during the postpartum period. He also discussed a digital program developed during COVID-19 to help individuals with eating disorders. The presentation concluded with information on training opportunities for clinicians to use the CFT approach in NHS accessible services.
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