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Eating disorders in pregnancy

Eating disorders are up to four times more prevalent in females as compared to men and pregnancy can be a very challenging period. Eating disorders usually present with abnormal eating habits involving either insufficient or excessive food intake, a range of compensatory behaviours and psychological conflict and distress. It is important that there is an improvement in your eating disorder prior to trying for a baby because being of a low weight and engaging in behaviours to compensate for the food you eat can compromise your fertility.

Person eating a meal

A healthy weight promotes ovulation. Many women with eating disorders may experience a disruption in their hormone production, and periods may not be present. If this is the case they are less likely to ovulate and release a mature egg, which would enable them to become pregnant. Women with Bulimia Nervosa can be of normal weight, but can still have severe nutritional deficiencies that can affect their fertility. Research has shown that once a healthy dietary intake has been resumed, problem behaviours have reduced and weight improved, women with eating disorders can expect to resume their menstrual cycle.

Fulfilling your role as a mother by supporting your growing baby during pregnancy and once your baby has arrived requires great physical and emotional strength, so it is important that you are at your best possible health.

During your pregnancy, it is advisable that you seek specialist medical, dietetic and psychological help to enable you to cope with your pregnancy and eating disorder symptoms. Support is available to you via your GP, Midwife, Health Visitor and within Primary and Secondary Care Services.

Is it also recommended that you inform your Obstetrician about your illness in order that appropriate support and monitoring can be provided.

It is important to eat well-balanced meals and to stay hydrated with plenty of fluids during pregnancy. The 'average' woman gains between 25-35 pounds during a healthy pregnancy. As the foetus develops, it takes nourishment from the mother. If she suffers from an eating disorder this can seriously deplete her own reserves and she may begin to experience exhaustion and low mood.

Consult with a specialist eating disorders dietitian before, or as soon you know you are pregnant. With their help, you can create a healthy eating plan to support your own physical and emotional wellbeing during pregnancy, as well as the development of your growing baby. After the arrival of your baby you may wish to continue to see the dietitian for help and advice on returning to a weight you are comfortable with through healthy means.

Although this is happy news for most women, for those experiencing eating disorders the confirmation of being pregnant can create an uncomfortable mix of emotions. Pregnancy may have a positive or negative impact on a woman's eating disorder and this may be difficult to predict at first. Your eating disorder may exacerbate the fears that most women have anyway; surrounding weight gain, changes to body shape and disruptions to life routines. Some women find that they develop better control over their eating disorder symptoms during pregnancy, which is motivated by the desire to have healthy babies and be healthy themselves in order to provide the best care for them. However, some women continue to have difficulties with poor/distorted body image and are unable to distinguish being pregnant from being "overweight". There is also a common fear that the weight gain during pregnancy will be become out of control.

Express your wishes regarding your preferred choice of health worker. You can use your appointments with them to express your hopes and fears about your changing body.

Become educated - read pregnancy books and articles, talk to others, and attend your antenatal classes.

Take some quiet time to reflect on the wonder of your changing body and how these are supporting the needs of your baby. Be kind to yourself and indulge all your senses to make your body feel pampered and relaxed.

Many women with active or past eating disorder take medication, such as antidepressants. Medication is an important part of life for a lot of people and it should not be discontinued suddenly as it may lead to a deterioration in your mental health. Ideally, it should be discussed with your GP or Consultant before, or as soon as you find out that you are pregnant to ensure the best outcome for you and your baby. It is crucial to protect your emotional health and wellbeing as pregnancy is a major psychological and physical adjustment.

There are medications that are safe to take during pregnancy and when breastfeeding.

The outcome of pregnancy may be compromised in women with disordered eating.

Possible risks to you and your baby include:

  • Poor nutrition
  • Dehydration
  • Cardiac irregularities
  • Gestational diabetes
  • Depression
  • Labour complications
  • Premature birth
  • Low birth weight for age
  • Respiratory distress
  • Difficulties feeding
  • Delayed development

The above risks can be minimised by significantly reducing disordered eating patterns, including restricting intake or binging and purging, maintaining a healthy weight before conception and allowing the desirable weight gain during pregnancy.

 

  • Ensure a better wellbeing both emotionally and physically prior to conceiving.
  • Inform your obstetrician of your eating disorder and know what additional help is available.
  • Consider working with a dietitian who has specialist experience of eating disorders to ensure your diet and weight in maintained throughout the pregnancy.
  • Consider engaging in help available from local mental health and eating disorder services to help you anticipate and manage the challenges of pregnancy and parenting.

Firstly, congratulations! Now your baby has arrived.

Due to the potential risks of developing postnatal depression which has an association with eating disorders, just be aware of prolonged mood changes and seek help from your GP or Midwife if this becomes too distressing. If you feel your mood has deteriorated you should consult with your GP to assess what is most suitable help for your needs. Your Doctor is able to discuss this with the Perinatal Mental Health Team's Consultant Psychiatrist if needed.

Mums wishing to breastfeed their babies may wish to seek help from their Midwife or Health Visitor who are available to support you in addressing your goals in feeding your baby.

Please don't forget about contraception, this is very important!