First Trimester Body Image Challenges

An anxious pregnant woman is looking at the window while holding her baby bump

Staying Committed to Recovery

First trimester bloat is… a whole thing. Your jeans don’t fit, there’s no cute bump yet, and if you’ve ever struggled with body image or your relationship with food, it can mess with your head in a big way. It’s such a weird in-between stage: your body is changing so much, but you don’t look pregnantttt pregnant. It’s not firm and cute yet… more like you over-ate.

If you ever experienced yo-yo eating, restriction then bingeing, and the shame that comes with that cycle, it can be mental gymnastics to remind yourself that this is the amazing thing you hoped (and maybe even worked hard) for. It can take a lot of energy to rewire the old pathways that tell you that feeling and looking full and bloated mean you did something “bad”, and to remember that this is your body’s healthy and normal response to an exciting change.

TF-CBT-E Tools for First Trimester Bloat

Try these TF-CBT-E (Trauma-Focused Cognitive Behavioral Therapy for Eating Disorders)-inspired tips and tools that can help with the mental and emotional challenge of first-trimester bloat, especially for someone who has a history of body image struggles or disordered eating.

These are gentle, pregnancy-safe adaptations:

A pregnant woman is looking at her belly

Thought Record for Body Image Triggers:

Pregnancy bloat can activate old thoughts like “I’m gaining weight too quickly” or “I look huge.” Use a TF-CBT thought record to challenge them.

Example:

Situation: Jeans feel tight at 9 weeks —> Thought: “I’m out of control.”

Try swapping that thought for, “My body is doing something new and temporary; this isn’t about control.”

Narrative Reframe: Your Body as a Story

TF-CBT often uses narrative work to integrate trauma. Write a short paragraph about this season of your body’s story: “Right now my body is bloated and uncomfortable because it’s creating a safe environment for this pregnancy. This discomfort doesn’t erase my past experiences with food and body image; but it adds a new chapter where my body is showing its strength.”

If you’re feeling all kinds of feelings about your body changing, know you’re not alone. Follow for more Pregnancy Mental Health topics.


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Our Services

At HLH Therapy, our relational therapists offer virtual therapy for individuals and couples in New York, New Jersey, & Florida. We specialize in Maternal Mental Health (including infertility, IVF, pregnancy, and postpartum), Eating Disorders, Disordered Eating, Body Image, Anxiety, Depression, Trauma, and Couples Therapy.

Would you benefit from support from a therapist? We offer free 15 minute consultations to determine best fit.

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The Emotional Weight Behind Body Image