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Pregnancy

How Eating Disorders can Affect Your Pregnancy

Jennifer Lincoln, MD, IBCLC, Board Certified OB/GYN
January 3, 2019 . 3 min read

Every year, 10 million American women deal with an eating disorder. While many of these women will stop having periods because of their low weight, some will still menstruate and become pregnant. How an eating disorder can affect a pregnancy can be a major concern for both a mother and her developing baby.

The two most common eating disorders are anorexia nervosa and bulimia nervosa. Anorexia is characterized by the extreme fear that a person is overweight, even when she is visibly dangerously thin. Women with this disorder will often severely restrict the calories they eat, exercise excessively, and use laxatives to increase weight loss by having frequent bowel movements. On the other hand, women with bulimia will binge eat. This means that in one sitting they may eat a huge number of calories, followed by purging, or self-induced vomiting. Where many anorexics are so thin they appear sickly, many bulimics are often a normal weight.

Getting pregnant while struggling with an eating disorder can be extremely overwhelming for a woman. Pregnancy is a time of increased medical attention, and this includes having weight checks at every prenatal visit. Some women with eating disorders may skip appointments so they don’t have to step on a scale, thereby missing important appointments and tests.

Most women with an eating disorder have some understanding that how they eat is not normal or healthy, and being pregnant on top of this can make them feel even guiltier. They may know that they need to gain weight to help their baby grow, but because of their disorder they may sink into deep depression or experience severe anxiety at the idea of becoming “fat.” They may also feel out of control as their uterus and abdomen grow despite everything they are doing to stay thin.

Medically speaking, having an eating disorder during pregnancy can be dangerous for both a mother and her growing baby. The following increased risks have been linked to eating disorders in pregnant women:

Dehydration and electrolyte imbalances in the mother

Maternal cardiac irregularities, such as arrhythmias which can be fatal

Worsening antenatal depression and anxiety

Preterm labor and birth

Growth restriction and low-birth weight babies

Respiratory distress in the newborn

Women with eating disorders who are pregnant should be upfront and honest with their obstetric provider and know that they will not be judged for admitting they need help. Doctors or midwives will make sure they receive extra care, such as from a qualified nutritionist, psychiatrist, or support group. Another technique that may help is by covering the scale during weight checks and only alerting the woman when her weight gain is abnormal so she needn’t hear about how much she has gained. Additional ultrasounds of the baby may be ordered to make sure he or she is growing appropriately.

Even after delivery, it’s important that these women continue to have frequent care. Many try to lose the weight that they’ve gained in a very quick and dangerous manner, and it is important to check in with them frequently to make sure they are a safe weight and are not suffering from postpartum depression.

Sources:

  • The American Congress of Obstetricians and Gynecologists
  • Your Pregnancy and Birth
  • 4th ed.
    National Eating Disorders Association
  • Pregnancy and eating disorders.

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