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Coping with an Eating Disorder during Pregnancy

Coping with an Eating Disorder during PregnancyAs many as 4% of women suffer from anorexia or bulimia, with the rates of binge-eating disorder believed to be even higher(1). While disordered eating is a risk factor for infertility(2), as carrying too little or too much weight can disrupt your menstrual cycle, it is still possible to fall pregnant before you have made a recovery. Even though there are risks associated with pregnancy when you have an eating disorder, it is still possible to have a good outcome for both you and your baby when you have the right support.

Impact of pregnancy on disordered eating

Pregnancy is an exciting time, but it can also bring anxiety, particularly if you suffer from disordered eating. Often poor mental health can contribute to eating disorders, so it is not surprising that with the changes that occur during pregnancy this can have a negative impact on how you feel, which in turn influences your behaviors. Weight gain and the way your body changes shape during pregnancy can worsen a pre-existing eating disorder or trigger a recurrence. Anxiety surrounding weight changes can encourage you to restrict your diet, over-exercise, abuse laxatives and vomit more, all of which can potentially harm you and your developing baby. However, you may find that your eating behaviors actually improve while pregnant due to concerns that your habits will adversely affect your unborn baby.  For instance, although women with anorexia nervosa typically start pregnancy with a lower body weight than other women, they gain weight more quickly than women without an eating disorder, which may explain why birth weight, early labor and pregnancy complications are not necessarily higher(3).

Pregnancy risks linked to eating disorders

As understanding the risks associated with an eating disorder while pregnant can have a positive impact on the decisions you make regarding your food choices and behavior, here is a summary of the potential risks to mother and baby(4):

Poor dietary intake can take its toll on your health even more when you are pregnant, as your body prioritizes your baby for delivery of nutrients, which increases your risk of nutritional deficiencies further and makes you more susceptible to health problems in later life such as osteoporosis. Your body will also struggle to produce enough milk for your baby when your dietary intake is compromised. If you use laxatives or vomiting as a way to control your weight, you are more likely to develop dehydration in pregnancy, which can lower your blood pressure too much, lead to muscle cramps and restrict the amount of amniotic fluid surrounding your baby. As laxative abuse and vomiting also remove vital electrolytes, this can disturb the electrical activity of your heart and lead to irregularities in your heartbeat. Meanwhile, if you have binge eating disorder and you are overweight, this increases your risk of developing dangerously high blood pressure and diabetes during pregnancy, as well as complications during labor. As depression is more likely among women with eating disorders(5), you are also more vulnerable to antenatal and postnatal depression.

If you are unable to take control of your eating disorder during pregnancy, you increase the chance that your baby will suffer from developmental problems in the uterus and they are more likely to be born early and have a low birth weight for their age. Babies born to mothers with disordered eating are also at increased risk of breathing and feeding difficulties shortly after birth.

Achieving a successful pregnancy

Although it is recommended that you resolve disordered eating behaviors before trying to conceive, if you fall pregnant before completing recovery there are steps you can take to increase the likelihood of a healthy pregnancy(6). Firstly, you should make an appointment with your doctor as soon as you discover you are pregnant and be honest about the difficulties you have with eating; they will probably want to monitor the growth and development of your baby more closely so may schedule extra prenatal appointments. You should also ensure you receive one to one counseling to help you address your concerns regarding eating, weight gain, your body image and your new role as a mother, all of which can have a positive impact on food intake, exercise levels and purging behaviors. Joining a support group for women with eating disorders may additionally help you during pregnancy. As well as counseling, you should invest in the services of a nutritionist to help you achieve an appropriate diet to support you and your developing baby.

Written by Helen Ball


1 “Eating disorders statistics,” National Association of Anorexia Nervosa and Associated Disorders, accessed November 19 2014

2 “Risk factors for infertility,” Mayo Clinic, accessed November 19 2014

3 “Eating disorders and their impact on pregnancy outcomes,” Massachusetts General Hospital, accessed November 19 2014

4 “Pregnancy and eating disorders,” National Eating Disorders Association, accessed November 19 2014

5 “Eating disorders,” Cleveland Clinic, accessed November 19 2014

6 “Pregnancy and eating disorders,” American Pregnancy Association, accessed November 19 2014


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