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.

If you’ve found that 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 of an eating disorder 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

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.

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

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.

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

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.

Warning signs

Physical

• Changes in weight (loss, gain, fluctuating)
• Fainting or dizziness
• Fatigue or lethargy
• Bloating or constipation
• Compromised immune system

Behavioural

• Repetitive dieting
• Obsessive behaviours around food, body shape, and
• weight
• Changes in food preferences
• Secretive behaviour around eating and/or exercise
• Avoidance of or changes in behaviour around social
• situations involving food
• Evidence of vomiting, misuse of laxatives, and/or
• appetite suppressants

Psychological

• Preoccupation with eating, food, body shape and/or
• weight
• Low self-esteem and feelings of shame
• Body dissatisfaction or negative body image
• Difficulty concentrating
• Depression and anxiety
• Heightened sensitivity to comments or criticism

Eating disorders and mental health

Eating disorders have been associated with increased risk of anxiety and depression both during pregnancy and in the year following birth. There has also been an association between eating disorders and obsessive compulsive disorder (OCD)during pregnancy.

This is why your health team need to know how your mental health is tracking during your pregnancy and early parenting journey.

Treatment for eating disorders during pregnancy

It is important to let your health professional (e.g.GP) know about your experience of an eating disorder so that they can ensure you have the right supports in place including specific eating disorder care.

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.

People experiencing an eating disorder may have a higher risk of iron deficiencies during pregnancy or may miss out on key nutrients. Speak with your health professional about monitoring your levels, and you may ask to see a Credentialed Eating Disorder Dietitian for more advice on getting the nutrients that you and your baby need.