What is Hyperemesis?
Hyperemesis gravidarum, also known as HG, is a severe and debilitating condition that can affect pregnant individuals. HG causes relentless and excessive nausea and vomiting during pregnancy. Unlike the more common morning sickness, hyperemesis gravidarum can be particularly distressing, leading to severe dehydration, weight loss, and a significant decline in overall quality of life. Even with early treatment and medication for symptom reduction, many women do not find relief until after birth.
Hyperemesis Gravardium and Eating Disorders in Postpartum
A common concern many HG survivors face in postpartum is navigating their relationship with food. Many clients find their relationship with food and body image to be extremely difficult and sometimes chaotic in the postpartum period. A large percentage of Hyperemesis Gravardium clients experience postpartum emotional eating, binge eating episodes, and other disordered eating patterns.
This is not a surprise after nine months of severe vomiting, dehydration, food aversion, weight loss, and other medical complications. Unfortunately, it is another battle HG survivors may face. HG is a unique medical illness, where physically you experience uncontrolled vomiting, however, psychologically the desire to eat and nourish your growing baby is still present. This creates a psychological dilemma of Illness-related food deprivation and helplessness. The psychological stress created by starvation, deprivation, chronic vomiting, nausea and food aversion can deeply harm the ability to eat intuitively.
Some aspects of HG-related trauma can be medical complications, hospitalizations, and minimization of the severity or authenticity of illness by medical providers. HG-related trauma can also present as a desire to control food, food aversion, flashbacks of vomiting, fear of vomiting, and intrusive thoughts related to the time of HG. This leads to a very distressing relationship with food, eating and body image during the post-partum period.
Delivery often marks the end of nausea and vomiting symptoms for those diagnosed with HG. For others, it can take a few days for the HG symptoms to fully resolve. However, many report their ability to resume eating as both exciting and fearful due to food's connection to uncontrollable illness.
Hyperemesis Gravardium increases risk for Postpartum Depression and Anxiety
Even with the remission of nausea and vomiting, those who faced HG through pregnancy still face underlying depression, anxiety, and trauma. This can be greatly exacerbated by the exhaustion and lack of sleep a newborn brings. This increases the risk for future diagnoses of postpartum diagnoses of depression, anxiety and OCD. Many report their relationship with food feels out of control, fears of eating too much, fears of vomiting returning, and eating large quantities of food. The psychological experience of starvation, deprivation, and malnutrition coincide with patterns of disordered eating. Feeling out of control once again with food can propel new mothers deeper into a binge-restrict cycle.
Warning Signs for Postpartum Eating Disorders
Signs you are struggling with Binge Eating in Postpartum:
eating large amounts of food and rapidly eating
eating in secret, hiding wrappers or the evidence
feeling guilt and shame after eating
feeling out of control with food
can lead to feeling physically sick
urges to eat when not hungry
Signs you are struggling with Emotional Eating in Postpartum:
eating in response to emotions both positive or negative
soothing or coping with food
eating for relaxation or escape
eating when not hungry
When it's time to get help:
Your loss of control over food and emotions is getting worse or hasn't changed
You have more days struggling with food than not
Food and eating is your only enjoyable activity
You need support with nutritional rehabilitation
You feel immense shame and guilt after eating
Ways to address disordered eating and emotional eating during the postpartum period:
Navigating Intuitive Eating in Postpartum
Reject the bounce-back and snap-back culture
Honor your Hunger
Make peace with food and give yourself permission to eat all foods
Explore foods that feel satisfying, including textures, tastes, temperatures and smells
Feel your fullness and satiety
Learn to cope with your emotions in new ways
Joyful movement, Body respect, and body neutrality
Adopt a gentle nutrition mindset
Get Help
There are many ways to seek help. Consult a therapist, psychiatrist, and doctor for postpartum mental health concerns and underlying mental health complications of HG.
Authored by, Sasha Taylor, LMFT, CEDS. Eating Disorder Specialist and Perinatal Mental Health Therapist in Claremont, CA.