How Eating Disorders Impact Pregnancy: Risks, Weight Gain, and Anorexia Nervosa
While a variety of conditions can complicate pregnancy, eating disorders may have a number of distinct effects that can make pregnancy particularly challenging. These disorders can affect both the physical health of the pregnant person and the development of the baby, leading to potential risks and complications. In order to fully understand the associations between eating disorders and pregnancy, it may be beneficial to begin by learning more about what eating disorders are and what symptoms they can cause.
What are eating disorders?
According to the American Psychiatric Association (APA), an eating disorder is a behavioral condition that can affect a person’s social, physical, and psychological function. Eating disorders can disturb how a person thinks about and interacts with food. The APA estimates that 5% of the population experiences symptoms of eating disorders. While individuals of any age can develop an eating disorder, these conditions may be more likely to occur during young adulthood and adolescence.
Can eating disorders occur during pregnancy?
Which eating disorders are most common?
In 2020, the one-year prevalence rates for common eating disorders were as follows:
- Binge eating disorder: 0.96% for females and 0.26% for males
- Bulimia nervosa: 0.32% for females and 0.05% for males
- Anorexia nervosa: 0.16% for females and 0.09% for males
Eating disorders can present with unique symptoms that may have negative effects on those experiencing them, including during pregnancy.
What is binge eating disorder?
- Eating an amount of food that could be considered larger than what most people would consume in a similar period of time (for example, within a 2-hour period)
- Feeling a lack of control over one’s eating. This can manifest as the feeling that a person cannot stop eating, control what they are eating, or control the quantity they eat.
- A tendency to hide episodes of binge eating or to eat in secret
- Feelings of shame or guilt around eating
- Significant changes in weight
- Low self-esteem
- Frequent failed attempts to diet
- Social withdrawal
- Concerns with body weight or shape
- Use of laxatives and diuretics
- Forced vomiting
- Excessive exercise
- Excessive fasting
- Difficulty stopping eating, even if one doesn’t want to continue
- Specific habits or rituals built around eating
- Feelings of anxiety or depression
- Attempts to hide binging or purging behaviors
- Throat inflammation or pain
- Fatigue
- Erosion of tooth enamel
- Low body weight
- Significant preoccupation with eating
- Fear of gaining weight
- Excessive exercise
- Dehydration
- Thin nails and hair
- Yellowed skin
- Fatigue
Can pregnancy weight gain affect eating disorders?
Besides weight gain, how can pregnancy and eating disorders impact one another?
According to the American Pregnancy Association, eating disorders can have several effects on an otherwise healthy pregnancy, such as:
- Respiratory challenges
- Labor complications or premature labor
- Fetal death or stillbirth
- Fetal growth delay
- Low birth weight
- Increased risk of miscarriage
- Depression
What treatments can help people with eating disorders during pregnancy?
Treatments for eating disorders
One therapeutic approach that may be effective for the treatment of eating disorders during pregnancy is enhanced cognitive behavioral therapy (CBT-E). CBT-E can offer a personalized approach to eating disorder therapy by providing a way for individuals to analyze their condition and understand how to stabilize their eating patterns. This type of treatment may also help individuals find ways to overcome setbacks they may face in addressing the challenges of their disorder and maintain the changes they make going forward.
While CBT-E and other types of therapy may be beneficial for pregnant individuals experiencing eating disorders, in-person forms of therapy may not always be convenient. In some cases, pregnant individuals may not have the time to schedule appointments or travel to a therapist’s office. Others may live in a remote region or an area that doesn’t have a sufficient number of mental health professionals. In these situations and many others, alternatives like online therapy may be beneficial.
Research suggests that online therapy can be as effective as in-person therapy for the treatment of several mental health conditions. In a 2022 meta-analysis and systematic review, researchers compared data from multiple studies to determine the comparable efficacy of these therapeutic formats. Their analysis, which included 12 studies and 931 total patients, found no significant differences between online and in-person therapy on a variety of outcomes. These outcomes, which were measured both immediately after treatment and at 3, 6, and 12 months, included symptom severity, overall improvement, function, working alliance, and client satisfaction.
Also, individuals don’t have to be diagnosed with eating disorders to see an online therapist. Online therapists often treat people with a variety of mental health problems, relationship challenges, eating disorders, and body image concerns.
If you’re experiencing an eating disorder, during pregnancy or not, know that you don’t have to face it alone. Take the first step toward getting help with an eating disorder and reach out to BetterHelp today.
Can pregnancy trigger eating disorder?
Women experiencing eating disorders can have difficulty as they strive to have a healthy pregnancy, but are beset by fears about weight gain, navigating body changes, and they may begin to feel a strong need to control what they eat for the sake of their own body and that of their unborn baby.
Do people with eating disorders have a hard time getting pregnant?
Studies show that eating disorders affect fertility, with those who experience anorexia nervosa or bulimia nervosa demonstrating less chance of pregnancy than the general population, although researchers don’t yet have a clear answer to why. Many experts suspect that hormonal changes and body weight fluctuations during pregnancy have something to do with it, and also note that these effects are reversible with returning to a healthy weight through treatment for eating disorders.
How do you deal with weight gain while pregnant if you have eating disorders and pregnancy?
People with eating disorders should work closely with their doctor to manage symptoms and ensure a healthy pregnancy with well-balanced meals, normal weight gain, and personalized care. Even someone who has successfully managed their eating disorder may find it more difficult not to focus on their own weight, or worry about control during the hormonal fluctuations and changing body functions and shape during pregnancy.
Does anorexia nervosa affect pregnancy?
Eating disorders affect pregnancy in most women experiencing eating disorders, especially if they are dealing with one as serious as anorexia nervosa. Symptoms can be triggered during pregnancy, and if not eating healthily and maintaining normal weight gains during this time (especially the first trimester), there can be serious pregnancy complications including:
- Premature birth
- Low birth weight
- Poor development
- Feeding difficulties
- Gestational diabetes
- Perinatal or postpartum depression
- Labor complications
- Cardiac irregularities
Can eating disorders cause miscarriages?
Miscarriages are a potential complication of an untreated eating disorder during pregnancy. It is important that if you are diagnosed with an eating disorder during pregnancy, or if you have had symptoms of one in the past, to work closely with your doctor to ensure that you are taking proper care of your body and your pregnancy. You may also want to keep in close contact with friends and family members to help protect your mental health.
Yes, depriving your body of nutrition while your fetus is developing can cause dangerous complications for your baby, as well as impact your own health. If you feel symptoms of eating disorders, it is important to work with medical and mental health professionals to focus on your own health and the health of your child. You may also want to work with a health visitor for a time during the pregnancy postpartum period so you can focus on your treatment plan.
Being underweight during pregnancy can increase the risk for certain complications such as preterm birth, low birth weight, or nutritional deficiencies in the mother. If underweight, it is a good idea to work closely with your obstetrician to create a healthy eating plan and ensure that you and your baby are getting the nutrition you need during pregnancy and beyond.
What are the effects of eating disorders during pregnancy?
Poor eating habits during pregnancy can exacerbate already unpleasant physical signs like morning sickness, as well as increased risk for postnatal depression, birth complications, and nursing difficulties. It can also impact the baby, with increased risk of low birth weight, respiratory issues, and developmental problems.
Can eating disorders relapse after pregnancy?
What happens if you have eating disorders and pregnancy?
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