Starving For Two

When Carrie Smith was pregnant with her fourth child, she wasn't surprised to be diagnosed with gestational diabetes for a fourth time. What shocked her was the resurgence of her eating disorder demons.

By Carrie Myers Smith

I loved being pregnant — knowing that I was housing this tiny human being, feeling the baby roll around inside me, hearing the heart beat echoing like a galloping horse from the Doppler. It is all so miraculous!

The first three times I was pregnant, I welcomed the roundness of my protruding tummy. It was the only time in my life when I didn't worry about gaining weight. Then, pregnant with my fourth son, I found myself staring down old demons.

When I tested positive for gestational diabetes the fourth time, it came as no surprise. Although I wasn't over 30, or obese — the normal risk factors that predispose a woman to gestational diabetes — I knew it was likely to happen again.

Doctors had explained to me that like other forms of diabetes, gestational diabetes occurs when the body is unable to properly metabolize sugar. What they couldn't explain was why some non-diabetics, like myself, develop the disease during pregnancy.

But, whatever the cause, this diagnosis meant my body could no longer properly process the nutrients in the food that I ate — and this when I was supposed to be eating for two!

The turmoil began. My doctor prescribed a strict diabetic diet, and I began to time my workouts around my meals. In fact, everything revolved around my meals. Suddenly food was at the center of my universe — again.

For some people, sticking with a strict diabetic diet can be extremely difficult, but for me it was easy. Having suffered from anorexia nervosa in high school and college, I was a master at restricting what went into my mouth. And now, years later, I found myself resorting to some old, dangerous habits.

When I was younger, anorexia had been a tool for survival. When I couldn't control certain areas of my life, I took command of what I could control — food. And although I had "recovered" from anorexia many years prior, like an alcoholic who is always in recovery, I never fully conquered the illness.

Now, here I was pregnant and trying to manage diabetes. Little did I know that my history with anorexia would put both me and my baby at risk.

I was unprepared for how difficult it would be to keep my blood glucose in the normal range. Unlike the first three times, with this pregnancy the changes I made in my diet and exercise just weren't enough.

The doctor said that if I couldn't get my glucose levels down, I would have to take insulin. But, in my mind, there were no options. Taking insulin would mean admitting defeat.

I thought about food constantly. When I had problems keeping the levels down, it triggered a switch in my head. I had to take charge. I could control this, I thought. And the battle began.

I cut calories mercilessly and increased my exercise until my husband told me he thought I was overdoing it. But it worked. My blood values dropped into the normal range. The only problem was, I began to lose weight.

If I continued down that path, this problem of mine could end up becoming my baby's. After all, for the health of my baby, I was supposed to be gaining weight, not losing it.

When I got on the scale at my next office visit, my doctor didn't hesitate. Despite all my efforts at blood sugar control, I had to take insulin.

Although I didn't argue, I felt like a failure. At the time, I didn't think that I was anorexic again, just that I was on a mission to control the blood glucose.

I took the shots, but the struggle for normal glucose values didn't end there. It took weeks of adjusting insulin dosages, caloric intake and exercise before we found the right combination.

As each day passed, the need for control set in deeper and deeper. It consumed my life. I wasn't used to failing so miserably at something so intimately connected to me. It was the true paradox of an eating disorder: while I thought I was in control, the disorder had actually engulfed me.

I remember the day when I stepped on the scale in the doctor's office and realized that I had lost a pound. I wanted to rejoice, as if I was in some weight loss program and it was weigh-in day. But when my hand brushed across my enlarged belly, it pulled me back to reality.

That moment woke me up to the possible consequences of my behavior. Although the baby's health had originally fueled my desire to control the blood glucose, it had ended up second to my need for control.

In the end, we found the right combination. And we celebrated when our fourth son was born healthy. I found I was able to conquer my demons when I realized what was really at stake here: the health of my son.

Carrie Myers Smith is a freelance health and fitness writer with a B.S. in exercise physiology and health education who resides in the White Mountains of NH with her husband and four sons. If you have questions or comments, she can be reached at: cmsmith@landmarknet.net.

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