Eating disorders during pregnancy
For some women, body changes during pregnancy and the increased focus on weight and shape can result in a relapse of a previous eating disorder. Other expectant mothers may develop an eating disorder such as Bulimia Nervosa for the first time.
It’s estimated that the prevalence rate of eating disorders during pregnancy is around 7.5 per cent. There’s often considerable feelings of guilt and shame attached to this, which prevent women from seeking help.
I found being weighed so often during pregnancy was incredibly triggering. The focus on weight gain was really stressful.Meg
If you’ve found your eating disorder has actually improved during pregnancy, you’re not alone. For some women, focusing on nurturing their growing baby by eating healthily and staying active can help with symptoms or reduce their severity.
What are the risks for mum and baby?
Women with eating disorders during pregnancy have a higher risk of experiencing pregnancy complications such as premature birth and gestational diabetes. They’re also at higher risk of developing Hyperemesis Gravidarum (HG).
Here’s what we know from the research:
Anorexia Nervosa (AN) is characterised by restricted energy intake, which results in significant weight loss and low body weight. Those suffering from AN also experience an intense fear of weight gain and disturbance in body image.
I starved myself towards the end of my pregnancy because I was worried I was gaining too much weight. I’m so ashamed.
One study found that expectant mothers who were hospitalised due to anorexia were more likely to have a premature birth and have babies of low birth weight. There was also increased risk of stillbirth.
Bulimia Nervosa (BN) involves recurrent episodes of binge eating and a sense of lack of control. In addition, those with BN use inappropriate compensatory behaviours to avoid weight gain including purging, use of laxatives, fasting or excessive exercise.
Active bulimia during pregnancy is associated with postnatal depression, miscarriage, and preterm delivery.
Binge Eating Disorder
Binge Eating Disorder (BED) also involves recurrent episodes of binge eating. Unlike Bulimia Nervosa however, BED is not associated with the recurrent use of inappropriate compensatory behaviours such as purging or fasting.
During pregnancy I found I was able to keep my BED symptoms at bay. But after my baby was born, the stress made it hard not to relapse.Kate
According to recent research, one in three women binge eat during pregnancy making it surprisingly common. Expectant mums who experienced a loss of control over their eating during pregnancy consumed more calories and ate more snacks. They also gained more weight and had a lower intake of vitamins A, C and B6.
Another large study found that women with BED during pregnancy were more likely to have babies who weighed more at birth.
Pica refers to the persistent craving for, or eating of, non-food items such as earth, clay, chalk, soap and ice. It has been linked to iron deficiency in expectant mothers.
Treatment for eating disorders during pregnancy
It’s important to know that help for eating disorders is available. You’re not alone. Taking steps to receive treatment and support is not only brave but will help keep you and your baby healthy. It will also help you plan for the possibility of relapse after your baby arrives, which is also common.
While it’s not easy, being honest and upfront with your health team is crucial. This will enable them to safely monitor you and your baby. For many women, this involves taking a “team” approach with your OB-GYN or midwife, a mental health professional and a nutritionist or dietician.
I struggled with weight gain and poor body image during my first two pregnancies. When I was pregnant with my third baby, my OB and I agreed that I would stand backwards on the scales so I wouldn’t obsess about the numbers every time.Beth