Eating disorders can be long standing illnesses that stay with a sufferer even through the most substantially life changing events and circumstances. Pregnancy is an example of a life event that can be complicated by an eating disorder. Because eating disorders are not a choice, it is unlikely that becoming pregnant will lessen the way that a woman is affected by the illness. In many cases, pregnancy can worsen the condition.
“Pregorexia” is a term that was coined by the media to describe eating disorders that persist through or emerge during pregnancy. Calorie restriction, binge eating, purging through exercise or vomiting, using laxatives excessively and eating only particular types of food are all symptoms which may be experienced.
Studies suggest that 4 percent of women of reproductive age suffer from an eating disorder. The prevalence of these eating disorders that persist into and throughout pregnancy however, is estimated to be lower. This may suggest that for some women, controlling or overcoming their eating disorder is easier when they are pregnant. However, it may also be that, due to stigma and shame, fewer women admit to having an eating disorder while they are pregnant. It is estimated that only 44 percent of pregnant women with eating disorders admit to having an eating disorder.
Sometimes the eating disorder shifts when a woman becomes pregnant making diagnosis even more challenging. A Norwegian Study found that after 18 weeks of gestation, more women were diagnosed with Eating Disorder Not Otherwise Specified, whereas before pregnancy these women had been diagnosed with Bulimia Nervosa or Anorexia Nervosa.
The Norwegian Study, which looked into 41,157 pregnant women, also found that binge eating disorder was less likely to remit and more likely to arise during pregnancy than anorexia and bulimia.
Women who have a history of an eating disorder of any kind are at a greater risk for relapsing into eating disordered behaviors during pregnancy. Pregnancy is considered to be a stressful time, and for this reason, it can trigger an eating disorder. This is true for both women who have a history of the illness, and for women who prior to pregnancy, had no history of eating disorders.
For women who have sub-threshold level disordered eating symptoms, becoming pregnant can amplify these symptoms to the point of a clinically signficant eating disorder. This mostly affects women who have a problematic relationship with food already. However, in our weight phobic culture, weight gain during pregnancy can be stressful even for those women who do not have or do not develop eating disorders.
Signs and Symptoms
Failure of a pregnant woman to make the expected weight gains may signal an eating disorder. Skipping meals, calorie counting, obsessive food-related behaviors and a preference to eat alone are also potential warning signs. Heavy exercise is another potential problem and a sign that there is some stress related to weight gain. Other signs can be a generally heightened level of stress and irritable disposition.
Pregnancy and Eating Disorder Complications
It can be more difficult to diagnose a woman with an eating disorder when she is pregnant. The natural change in shape can camouflage what is actually happening. In most cases of people suffering from bulimia, the illness is not physically detectable, so outward appearance can be deceptive.
Diagnosing an eating disorder can be complicated at any stage of life. Pregnancy adds another degree to this and is a time when sufferers themselves may be less likely to understand that something is wrong. Families and loved ones may notice a change in behavior or an additional element of stress, but may dismiss their concerns and attribute the behaviors to the hormonal aspects of the pregnancy.
Pregnancy and Eating Disorder Treatment
If it is suspected that a person is suffering from an eating disorder while they are pregnant, it is important that treatment is sought. Like any eating disorder, the illness can have grave consequences. A woman who is pregnant is at an even greater risk if she is not receiving adequate nutritional support.
A 2008 study implied that there is an increased risk of neonatal complications and adverse pregnancy issues when a woman is suffering an eating disorder during her pregnancy. This points to the importance of early detection and treatment.
Without treatment, there are considerable dangers that are posed to both the mother and the baby. Low birth weight and premature birth weight often affect the baby, while the mother is more likely to miscarry and become dehydrated. She may also experience difficulties when nursing her child and have a greater risk of birth-related complications.
As with all kinds of eating disorders, this can be a severe condition and treatment should be given as soon as possible. A team of specialists should be consulted including a psychiatrist, therapist and nutritionist.
Written by Tabitha Farrar – 2014
Special Thanks to Maggie Baumann, MFT, CEDS