Shit Fat Pregnant People Get Told: The What (Not) To Eat Edition

[contents: diet talk, disordered eating, medical, food restrictions, fat hate]

Everyone and their mother has advice on what to eat when you're pregnant. It's in every book, every provider I've seen so far (and I've been rotating among people in the practice, so that's three so far) has told me what (not) to eat. Random strangers give you advice. Seriously. EVERYONE.

Some of this advice falls under "what to do for morning sickness", which... is another topic entirely and so annoying. I'll probably cover that at some other point. What I wanted to talk about is the recommendations you get for your "pregnancy diet".

A lot of the books and sites you read are.. yeah, okay. The "YAY YOU'RE PREGNANT HERE'S THE INFORMATION ABOUT THE HOSPITAL" book I got at my first midwife appointment has this type of recommendation. Eat a variety of foods, heavier on the fruits and veg, try to get some stuff with calcium and protein, etc. and so on. Fairly reasonable so far as it goes, even if it does completely ignore people who have varied needs or dietary restrictions, and completely ignores folks for whom regular food is not a thing.

In fact, all of these recommendations are like that, whether the generalized ones you read in the books, or the ones most doctors and midwives will tell you to your face. On food stamps? No room for that here. Limited income? Food desert? No time to cook (or no energy to cook)? WHATEVER. These recommendations don't give a shit about your "problems". In fact, my care providers have never tried to see if I'm food insecure, beyond a single question on the intake questionnaire (which was FIVE PAGES LONG and had NO ROOM TO ACTUALLY ANSWER QUESTIONS) about if I were worried in any way about "money". Not actually about food or housing, just "money".  And with one line to try to cram an answer in. An answer you're giving to someone you haven't met yet and aren't sure you can trust. Super.

So yeah. Then you get to the stuff that's said to you in specific. In theory, these should be better! They're coming, usually, from people who know you, some of whom know your medical history in detail! HAHAHAHAH WHAT A FUNNY JOKE. These examples are all drawn from what I've been told so far. Please share your own in comments!

**********

Try to get some protein and a fruit or vegetable together at every meal.

On the scale of 1 to "are you trying to kill me", this is like a three, at least for me. The explanation was that fruits and veg are good for you, and having some protein with it would make sure that your blood sugar was more even and you stayed full longer. Which... the staying full longer is, yes, straight-up diet language. On the other hand, when you get nauseated as hell when you start getting hungry, not getting hungry after twenty minutes is a definite feature.

The blood sugar thing, I'm not entirely sure if that was "you're fat so you'll get the diabeetus", or just general good advice. I do know from past experience that if my blood sugar drops, bad things happen. If you've ever heard the term "hangry", yeah. THAT. So things that can help me not get to hangry are always appreciated. (Interestingly, this happens approximately not at all now that my thyroid is being treated. So many interesting things that I just took as my normal seem to be turning to be "nope your thyroid was fucked".) But there is some research showing that you'll probably be in a better mood, and overall feel better, if you're not riding a blood sugar roller coaster. So... yeah okay.

Fruits and veg, I'm one of the people for whom those sorts of things are really good. I know people for whom fruits and veg in general, or extra fruit and veg, would be absolutely detrimental to their health. From fucking up your potassium levels, to aggravating things like ulcerative colitis, fruits and vegetables are not actually good for everyone! Sure, many people benefit from the whole "five a day" thing that has been a feature of US public health campaigns for years (recently replaced with "More Matters")... but not even CLOSE to everyone. Turns out people are individuals! SHOCKING I KNOW.

But what makes this really less annoying for me was the "try to". Because it signals to me that this recommendation is coming from someone who understands that eating "perfectly", whatever that even is, is really not an attainable or reasonable goal. And that if I reported that I hadn't done this more often than I did, the follow up would more likely be a gentle reminder along the lines of "well keep trying", rather than straight-up fat shame. It's really the only recommendation I've gotten that has even a hint of awareness that everyone is different.

Eat a small meal every two hours.

You hear this in dieting, you hear this sometimes in HAES, and WOOOO I heard it in pregnancy. Some of the thinking behind this one is the same as the previous recommendation - try not to ride a blood sugar roller coaster. Some of this is to hopefully prevent nausea - which is less useful when both eating and not eating make you nauseated as hell, as happened to me the first, oh, three months or so, but it's a nice thought.

But this ignores the fact that sometimes you're really just legitimately not hungry, and that is okay too! When trying to unlearn disordered eating patterns, it can be incredibly helpful to present food to yourself on a schedule. And even then, it's okay if you're not actually hungry at that time. Eating well isn't about adhering to a strict schedule, or limiting food intake, or restricting in any way, it's about meeting your body's actual needs. Eating a meal every two hours, no ifs ands or buts, is not actually a way to do that.

At this point though, this has become extremely practical for me, because I just cannot fit much food in my stomach. I can be super fucking hungry! And then I take like SIX BITES AND I'M FULL. It's intensely frustrating. If you follow me on Twitter you'll occasionally see me post things like "and for second dinner", because I eat... and then I need to eat again two hours later. It is so frustrating for me right now.

But again, that's me... it's common in pregnancy, especially later on after the uterus has grown significantly, for the pressure this exerts on one's internal organs to make it more difficult to eat. Not guaranteed though. And eating every two hours isn't always the best plan for everyone. Even for me, where this does work pretty well, it varies day by day, as well as by time of day (I tend to be way hungrier in the evening). So again, shocker, PEOPLE ARE INDIVIDUALS. Not that this is reflected in most advice.

Avoid white foods.

This shit alternately makes me laugh and seethe. This was from the same midwife who told me to "only gain 10 pounds". When she said this to me, I nearly blurted out "so... white meat chicken, pork, navy beans, apples, cauliflower... right?" I then thought "so... are you telling me I should be eating the things that in the US we stereotypically associate with Black people? Or I should be eating only Indian food? What?"

I mean it's just a bullshit recommendation on its face.

Usually when you see this what it means is "eat whole wheat bread, not white bread, eat brown rice instead of white rice, avoid potatoes and starchy things" etc. and so on. The rationale is usually OH REFINED FLOUR HAS NO NUTRITIONAL VALUE AND WHOLE GRAINS HAVE FIBER AND MICRONUTRIENTS.

Look.

There is literally no food that has zero nutritional value. I will repeat that. THERE IS LITERALLY NO FOOD THAT HAS NO NUTRITIONAL VALUE.

Literally none.

I mean, did you know you can get 10% of your RDA of iron from a serving of potato chips? And that anemia is ridiculously common in pregnancy, so it's important to get plenty of iron? Seriously. Potato chips have iron in them. Lots of things do. Every single food you could possibly eat has some nutritional value, both in terms of calories (which, you need calories, they are literally units of fuel), and vitamins/minerals. Every. Single. Food.

Additionally, a non-specific recommendation like this to NOT eat foods, to avoid an entire category of foods (even a category as loosely defined as "white foods") can be incredibly dangerous. I've talked about eating disorders and disordered eating before - blanket recommendations to avoid foods can be incredibly triggering for folks in those situations. Additionally, when a recommendation is based not on nutritional needs, but, as I have to figure in this case, the fear of the FAT and the DIABETES, it's not actually helpful, and can in fact be very harmful. Furthermore, the entire idea behind this is based in the notion that some foods are not "real" foods or are "OMG POISON" which... ugh, I don't even have the words for the contempt I have for those ideas. They're straight up diet culture and fat hate. And usually some racism and classism mixed in for good measure.

**********


So yeah. That's what I've heard so far. Mostly a bunch of one-size-fits-all, based-in-diet-culture-and-fat-hate, utter crap.

In the mean time, I'm working on eating when I'm hungry, and satisfying what I'm hungry for. Because I need to eat.