Friday, 26 February 2010

Stress in pregnancy as a contributory biological cause.

I am working hard at keeping up Waif's calorie count - catching her "swaps". For instance, this morning she ate an apple (about 53cal) and said that was instead of her fruit juice (94 cal for her 200ml apple juice). It can be no coincidence that her swaps are always for a lower calorie option. I negotiated an extra cheese string to make up the difference.

Last night, I bought Waif a slice of cheesecake and found half of it back in the fridge. I told Waif she needed to finish it (it was only a single portion as sold by Kruger in the picture). She did so but sulked immensely and said that had she known she had to eat the whole thing, she would have had a (mini) kitkat. This is despite the fact that she prefers the taste of the cheesecake, so I conclude that she is still struggling to eat calories freely. I suspect that true recovery will not happen until she is not calorie obsessed and eats for joy and from hunger. Perhaps anorexics never manage to regain a love of food - texture, flavour and social binding :-(

Rats, I have just realised that Waif volunteering to catch a bus from school to her after school tennis means that she won't get her half hour at home to have a hot chocolate and some toast before she plays. Hmmmm...... I will text her and tell her to buy some snacks at the school tuck shop and HOPE that she eats them. I need to warn her that if she has not gained wait at her next weigh-in then tennis will have to cease :-( That would be a shame.

Meanwhile, I have been considering the biological factors that predispose children to anorexia: I wondered why, at the initial interview, the Maudsley team asked me about my pregnancy and birth experience with Waif. I now realise why they did that. I now know that stress in pregnancy is a predisposing factor.

At the time, I said that the pregnancy was trouble free - it was, it was very straightforward even if I knew early on that I would be induced 2 weeks before my due date as I am a small build and Waif was a big baby.

I didn't mention, which I now believe could be contributory, that I suffered a lot of stress in my pregnancy from unrelated causes: my husband suffered from acute pain one evening when I was heavily pregnant and I had to get him to hospital (which was arduous with a reluctant opinionated and tired 20 month old in tow, being pregnant and my husband being 6ft 4 and unable at that point to walk unaided. We spent about 15 minutes trying to even get down the stairs from our first floor flat. I too ended up being treated in casualty as I dramatically passed out on arrival. Worse than that, when H came round from his acute operation for testicular torsion he had largely lost the ability to speak.

He was discharged from hospital without this lack of speech being addressed - the doctor made a classic comment to me. He said: "your husband never told me about it" !!! (d'oh, he can't speak) and refused to deal saying that we should go home and see our GP. Mind you, the area around my husband's bed was splattered with old, dried blood (not his own) and I saw a nurse administer 2 doses of insulin at once to the lady in the next bed and then fake the chart to say that she had given them at 4 hourly intervals (she had obviously forgotten earlier). I cannot believe this did the lady in question any good at all, so I was happy to get my husband away.

The GP was flummoxed and recommended a neurological appointment. Our appointment came through as being in 6 months time as his case was "not urgent". "But how can my husband, a lawyer, work without being able to talk?" "That's not our problem and doesn't make it a medical emergency."

My husband was looking at resigning and we both feared a brain tumour.

Meanwhile, I was having maternity discussions with my own employer - I was working full time in those days as we had little money - who told me that I could only have the 3 weeks statutory leave and had to come straight back to work after the birth or else they would make my life very difficult. They also wanted me to pay rent for my work accommodation for which noone else (all men) paid because "my husband ought to be providing for me". I did not tell them about my husband's medical problems because I would fight such an assertion on feminist grounds alone and we were trying to keep it quiet as my husband was trying to still work (diverting his phone).

TO cut to the chase, I was under a lot of stress for a while that I was pregnant with Waif: facing the prospect of being moneyless and having a husband at home who needed nursing as he died (worse case scenario) and being unable to give up my job as the only source of money, even if it would only just cover the nursery/ nanny fees for the soon to be 2 under threes, leaving us no money for food or bills.

My readers will be pleased to know that I managed to arrange a private neurological appointment (the best 200 we have ever spent) to then meet a sympathetic neurologist who gave my husband an NHS mri scan when he realised we were not insured, and diagnosed a simple epileptic type disorder in my husband which is easily controlled through drugs. So ultimately we were fine. Indeed, we have gone on to become rich on his earnings. But whilst I was pregnant with Waif, there were without doubt worries and now I wonder if those contributed to Waif's vulnerability to this horrid Eating Disorder......


  1. AM - it's really NOT your fault. Really.

  2. I agree with the other commenter. It's not your fault. I am a big fan of biological theories, but many women have stressful pregnancies, and only 1% of the population develop anorexia. The biological theory that makes the most sense to me suggests that people inherit a combination of genes which predispose them to anorexia, and these genes can be switched on or off depending on circumstances and environment. People DO fully recover, and it is possible that Waif will one day enjoy food again. In fact, most poeple with eating disorders love food and obsess about it, but are terrified of it. A lot of psychological improvements can't be seen until anorexics are fully weight restored so please don't think that Waif's behaviour shows she will always be ill. It just takes a lot of time. I know you have the link to the Maudsley Parents website on your blog but have you ever been on the Around The Dinner Table forum? It's a message board for parents of people with eating disorders, here: I admit to having a look there in the past out of curiosity and it seems like an incredibly useful source of support for parents. I know they would be able to reassure you that this is normal for Waif's stage of recovery, and that it doesn't mean she will never recover. She has every chance of going on to lead a healthy and happy life.