“There’s just this really mental battle that you go through when you’re pregnant, and your doctor is not being supportive, and you’re gaining weight, and they’re telling you it’s too much but you feel like you’re healthy” ~ Ruby, mother of one.

Healthcare professionals often do not have enough resources to help them identify and refer pregnant or postpartum women with eating disorders. This page is designed to provide a rapid assessment tool, easy referral guides, and resources such as a sensitivity training so that healthcare professionals feel more prepared to treat women during pregnancy and postpartum who present with an eating disorder or history of an eating disorder.

How can I assess my patient?

Resources coming soon

How do I refer my patient?

PregnancyPostpartum

Please enter your email below to be notified when these tools are available to download

Sensitivity
Training

This sensitivity training will be available soon and will be free to access. Items covered in this training will include how to address weight with patients, options for lower stress weighing, general information about eating disorders, and word choices related to food and weight.

CME
Course

This course will count towards Continuing Medical Education (CME) credits and will be available in the near future for a small fee.

As medical knowledge increases, so does responsibility. We are continually enlightened of more sensitive ways to approach conversations with patients. People with eating disorders can be sensitive to others and the vocabulary directed towards them (Kuipers, G., den Hollander, S., van der Ark, L.A., & Bekker, M. 2017). Research has shown that people who have eating disorders focus more on appearance-related words (Myers, Ridolfi, & Crowther, 2015). Staying up-to-date on positive and person-oriented terminology for patients is a responsibility for all who work with individuals who have eating disorders. Learn More

Terminology for Mental Health Professionals

Shifting the eating disorder voice during pregnancy

By Hattie Rowe
West Virginia University

Major changes in life can be stressful for anyone. But for women who have struggled with eating disorders, adapting to changes may look more difficult. People who suffer from an eating disorder have unhealthy coping strategies related to their body. Whether these life changes induce stress or excitement, adjusting to something new can elicit anxiety at the unknown. Learn More

Since weight and body image concerns are areas of concern for pregnant and postpartum women with eating disorders, it’s important to know the options around weighing whether you’re a patient or a clinician. Clinicians make these decisions around weighing on a case-by-case basis or have a conversation about weighing preferences at an early prenatal appointment. Patients may want to review this list to determine what options they feel most comfortable with and then engage their clinician in a conversation about their preference. Learn More

Options for Weighing

Relevant Blog Posts

February 2020 Sensitivity Training

February 2020 Sensitivity Training

February 2020 Sensitivity Training

By: Malerie Razzis

West Virginia University

This past February, the Healing Bodies, Healthy Babies research team was able to conduct their very first sensitivity training.  There were months of preparation prior to the first session with considerable work from team members including Zoya Khan, Caterina DeFazio, Taylor Shultz, Oghenerukeme Asagba, and Hattie Rowe.  During Summer 2019, the team worked in the WV STEPS lab to film examples of patient-clinician interactions.  These videos have been made available for the public to view on Youtube.  Prior to the first sensitivity training, all members of the Healing Bodies, Healthy Babies team also underwent the sensitivity training. 

The sensitivity training that was developed for the clinicians provided various clinical strategies that would be reasonable to integrate into their daily treatment of patients, particularly those with eating disorders and pregnancy.  Previous studies have laid some groundwork about the prevalence and characteristics of eating disorders in pregnancy, indicating a greater need for clinical understanding of eating disorder symptomatology and appropriate screening tools to be incorporated into prenatal and postpartum care.  Pregnant women with a history of eating disorders or an active eating disorder have a greater risk of giving birth to a child with lower birth weight, smaller head circumference, microcephaly, and small for gestational age (Kouba, Hällström, Lindholm, & Hirschberg, 2005).  Due to these health risks, it is important for clinicians to learn how to properly treat patients with eating disorders.  

A questionnaire was administered prior to the sensitivity training, as well as after the completion of the sensitivity training.  Prior to training, only 76% of clinicians indicated that a patient’s eating disorder history would be extremely relevant to their treatment.  Upon the end of training, this number increased to 96% of clinicians indicating that it would be extremely relevant to their treatment.  When asked about their comfort when treating patients with eating disorders, 61% of clinicians expressed being less than comfortable providing treatment.  After undergoing the sensitivity training, this number shifted to 84% of clinicians indicating that they were either somewhat comfortable or extremely comfortable with treating patients with eating disorders.  These results were promising to the Healing Bodies, Healthy Babies team.

Since this was the first sensitivity training, the results are preliminary.  “I am hopeful that once we conduct more trainings, we will have more data to analyze!  This will allow us to investigate the significance of our data and how the sensitivity training can be implemented to better aid clinicians,” reported Zoya Khan.  Khan is an undergraduate student that is an active member of the Healing Bodies, Healthy Babies team.  She would like to be able to administer the sensitivity training to a variety of clinicians including physicians, physician assistants, nurses, etc. in the future.  “Every person has a unique insight to offer, which will allow us to determine how we can provide clinicians with resources to treat patients with eating disorders,” she says.   Another goal that she has for the team is to continue developing free resources that are made available on the Healing Bodies, Healthy Babies website.  “I look forward to continuing to work with Dr. Claydon and the rest of the Healing Bodies, Healthy Babies team!”

References

Khan, ZA, DeFazio, C, Claydon, EA. “An evaluation of weight sensitivity training for clinicians” Poster presentation at the Spring Undergraduate Research Symposium, Morgantown, WV, April 2020.

Kouba S, Hällström T, Lindholm C, Hirschberg AL. Pregnancy and Neonatal Outcomes in Women With Eating Disorders. Obstetrics & Gynecology. 2005;105(2):255-260. doi:10.1097/01.aog.0000148265.90984.c3.

Terminology for Mental Health Professionals

Terminology for Mental Health Professionals

Terminology for Mental Health Professionals

By Hattie Rowe
West Virginia University

As medical knowledge increases, so does responsibility. We are continually enlightened of more sensitive ways to approach conversations with patients. People with eating disorders can be sensitive to others and the vocabulary directed towards them (Kuipers, G., den Hollander, S., van der Ark, L.A., & Bekker, M. 2017). Research has shown that people who have eating disorders focus more on appearance-related words (Myers, Ridolfi, & Crowther, 2015). Staying up-to-date on positive and person-oriented terminology for patients is a responsibility for all who work with individuals who have eating disorders.

The following terms have been proposed by researchers and professionals as more appropriate terms to use in conversation with patients who have eating disorders.

References:

Kuipers, G. S., den Hollander, S., van der Ark, L. A., & Bekker, M. H. J. (2017). Recovery from eating disorder 1 year after start of treatment is related to better mentalization and strong reduction of sensitivity to others. Eating and Weight Disorders, 22, 535–547. doi: 10.1007/s40519-017-0405-x

Lilienfeld, S.O., Sauvigne, K.C., Lynn, S.J., Cautin, R.L., Latzman, R.D., Waldman, I.D. Fifty psychological and psychiatric terms to avoid: A list of inaccurate, misleading, misused, ambiguous, and logically confused words and phrases. Frontiers in Psychology. doi:10.3389/fpsyg.2015.01100

Media Resources. Retrieved from https://suicidepreventionlifeline.org/media-resources/

Myers, T. A., Ridolfi, D. R., & Crowther, J. H. (2015). Reaction times to appearance-related or non-appearance-related word choice among women with and without eating psychopathology. Cognitive Therapy and Research, 39, 204–214.
doi: 10.1007/s10608-014-9653-5

Nielsen, E., Padmanathan, P., and Knipe, D. (2016) Commit* to change? A call to end the publication of the phrase ‘commit* suicide’. Wellcome Open Research, 1:2.
doi: 10.12688/wellcomeopenres.10333.1

Puhl, R. M., Peterson J. L., Luedicke J. (2013) Motivating or stigmatizing? Public perceptions of weight-related language used by health providers. International Journal of Obesity. 37: 612-9. doi: 10.1038/ijo.2012.110

Spencer-Thomas, S. (2018). Language matters: Why we don’t say “Committed suicide”. International Risk Management Institute, INC.
Retrieved from https://www.irmi.com/articles/expert-commentary/language-matters- committed-suicide

Weissman, R. S., Becker, A. E., Bulik, C. M., Frank, G. K. W., Klump, K. L., Steiger, H., … Walsh, B. T. (2016). Speaking of that: Terms to avoid or reconsider in the eating disorders field. International Journal of Eating Disorders, 49, 349–353.
doi: 10.1002/eat.22528

Options for Weighing

Options for Weighing

Options for Weighing

Since weight and body image concerns are areas of concern for pregnant and postpartum women with eating disorders, it’s important to know the options around weighing whether you’re a patient or a clinician. Clinicians make these decisions around weighing on a case-by-case basis or have a conversation about weighing preferences at an early prenatal appointment. Patients may want to review this list to determine what options they feel most comfortable with and then engage their clinician in a conversation about their preference. (more…)

Weight Gain Distribution

Weight Gain Distribution

Weight Gain Distribution

Weight gain and body shape changes can be very daunting during pregnancy especially for women who have an eating disorder or eating disorder history. However, it can be helpful to understand how the weight is attributed to the baby and how it is distributed. Being able to connect that weight gain specifically to the baby or pregnancy components can help the woman reframe the weight gain positively. (more…)

Shifting the Eating Disorder Voice During Pregnancy

Shifting the Eating Disorder Voice During Pregnancy

Shifting the Eating Disorder Voice During Pregnancy

By Hattie Rowe
West Virginia University

Major changes in life can be stressful for anyone. But for women who have struggled with eating disorders, adapting to changes may look more difficult. People who suffer from an eating disorder have unhealthy coping strategies related to their body. Whether these life changes induce stress or excitement, adjusting to something new can elicit anxiety at the unknown. (more…)

Clinical Page Quotes (all names are pseudonyms to protect the women’s real identities)

I would just hope that they would keep it on file and if they noticed anything, you know, maybe if I was appearing not to gain weight as quickly they could gently bring it up at that time. ~Kimberly

I didn’t do that thing where I asked them to weigh me backwards and not tell me or anything. I didn’t want to indicate that I had an issue with it. ~ Amelia, mother of one

I certainly felt a lack of … communication between psychiatric care and maternity care and needing some sort of, it doesn’t have to be a specialized midwife but just someone who can cross barriers and help you navigate your way through the pregnancy from both perspectives and not just one or the other. ~ Charlotte, mother of three

My doctor never knew any of this because I kept everything. Everything. No one knew anything. No one in the whole world. Only me. ~ Ann, mother of two

There’s just this really mental battle that you go through when you’re pregnant, and your doctor is not being supportive, and you’re gaining weight, and they’re telling you it’s too much but you feel like you’re healthy. ~ Ruby, mother of one

Watch our latest webinar here