Purging for Two

Dear Anonymous,

Yikes. An eating disorder during pregnancy can be very serious for the mother, the baby as well as the partner (psychologically and emotionally). Eating disorders affect approximately 7 million American women each year and tend to peak during childbearing years. Pregnancy is obviously a time when body image concerns are more prevalent, and for those who are struggling with an eating disorder, the nine months of pregnancy can cause disorders to become more serious. Anorexia and bulimia are most common. Both types of eating disorders may negatively affect the reproductive process and pregnancy.

Eating disorders affect pregnancy in a number of ways. The following complications are associated with eating disorders during pregnancy: Premature labor, Low birth weight, Stillbirth, Risk c-section, Delayed Fetal growth, Respiratory Problems, Gestational Diabetes, Complications Labor, Depression, Miscarriage, and Preeclampsia.

Women who are struggling with bulimia will often gain extra weight, which places them at risk for hypertension. Women with eating disorders have higher rates of postpartum depression and are more likely to have problems with breastfeeding.

The laxatives, diuretics, and other medications taken by many women with bulimia may be harmful to the developing baby. These substances take away nutrients and fluids before they are able to nourish the baby. It is possible they may lead to fetal abnormalities as well, particularly if they are used on a regular basis.

What You Can Do
During Pregnancy: Schedule a prenatal visit early in pregnancy and inform the health care provider (we recommend working with a Midwife and Nutritionalist that specialize in pregnancy health) the struggle with an eating disorder. Encourage healthy weight gain. Eat well-balanced meals with all the appropriate nutrients. Find a nutritionist who can help with healthy and appropriate eating. Avoid purging (if it's not obvious already). Seek counseling to address the eating disorder and any underlying concerns; seek both individual and group therapy. As you can see, we recommend a team approach.     Below are my responses to your specific questions. 

Do you think that this person is more likely going to be able to control themselves now? 

RD: Not likely. An eating disorder is a coping mechanism for something else that's broken or dysfunctional in a person. They may make sincere attempts at restraining themselves from disordered eating but eventually, without professional support, will slide back into their old patterns and end up feeling worse for failing to 'control' their behavior. In addition, remember that hormones are getting wacky during pregnancy. This individual is actually at their most vulnerable while pregnant. 

Is purging dangerous to the unborn baby? 

RD: As you can see above, it's extremely dangerous for the baby. 

Is it any worse than having morning sickness if a person is not currently having morning sickness? 

RD: Morning sickness is a biological reaction to changes in multiple hormones. It lasts for the first trimester for most women. Bulimia is a behavior and a choice - not a biological reaction. It does not go away like morning sickness. It starves the body of nutrients and is destructive. 

Is it necessary that a obstetrician know about the eating disorder or is this not something she needs to be made aware of? 

RD: It's absolutely necessary that medical professionals are consulted. The implications of bulimia are significant.