6. Eating Disorders

Maintaining a positive body image can be tough for any woman. During pregnancy, body image concerns seem to become even more prevalent. Eating disorders such as anorexia and bulimia seem to be more prevalent in women and tend to peak around the childbearing years. For women who are already struggling with an eating disorder, pregnancy can be a difficult time that can cause the disorder to worsen. Any type of eating disorder can affect the reproductive process and be dangerous during pregnancy.

Types of Eating Disorders

Anorexia nervosa is an eating disorder in which a person starves herself by eating little to no food. These people have a strong fear of body fat and weight gain. The most dangerous hazard of anorexia is starvation and its extreme health consequences. Obviously, for someone who is pregnant and whose food intake is responsible for supporting a fetus, anorexia could be detrimental. Not eating during pregnancy deprives the baby of essential nutrients she needs for proper growth and development.

Bulimia nervosa is an eating disorder in which a person binges, or consumes a very large amount of food all at once, and then purges by forcing herself to vomit or by taking laxatives or diuretics (water pills). The dangers of bulimia nervosa include electrolyte imbalances from repeated vomiting. Many people with bulimia are able to maintain normal body weight, making the disorder more difficult to detect.

Binge-eating disorder is very common in women. With a binge-eating disorder, a person is unable to control the desire to overeat. These people are not necessarily overweight or obese. The food they binge on is usually not nutritious but instead filled with fat, sugar, and calories.

Eating disorders can affect fertility and reduce a woman’s chance of becoming pregnant. Most women with anorexia do not have regular menstrual cycles, and about half of all women with bulimia do not have normal cycles. An irregular menstrual cycle can make it tough to get pregnant.

Effects on Pregnancy

Eating disorders can have a very negative impact on pregnancy. There are numerous complications that can occur and put you and your baby at higher risk. Some of these complications include the following:

• Premature labor

• Low birth-weight baby

• Stillbirth or fetal death

• Higher risk of C-section

• Low APGAR scores (the APGAR score is a quick evaluation of a newborn’s physical condition after delivery)

• Delayed fetal growth respiratory problems

• Gestational diabetes

• Complications during labor

• Low amniotic fluid, miscarriage

• Preeclampsia (toxemia)

• Birth defects

Pregnancy can exacerbate other medical problems that are related to eating disorders, such as liver, kidney, and cardiac damage. Women who struggle with bulimia usually gain excess weight during pregnancy, putting them at higher risk for hypertension or high blood pressure. Women who struggle with eating disorders through pregnancy also tend to have higher rates of postpartum depression, and they can have difficulty with breastfeeding.

If a women abuses laxatives, diuretics, or other medications to help get rid of calories during pregnancy, she can cause harm to her baby in many ways. These types of over-the-counter medications can also rid the body of valuable fluids and nutrients before they can be used to nourish and feed the baby. Over-the-counter medications, even if they are considered safe during pregnancy, can be dangerous when used in this manner or when used excessively.

How to Cope

If you struggle with an eating disorder, you may be at an increased risk for several complications during your pregnancy. It is vital that you take action immediately to increase your chances of having a healthy pregnancy and a healthy baby. You can still take steps to help ensure a normal pregnancy. If you are able to eat healthily and gain the normal weight that you should throughout your pregnancy, you should have no greater risk of complications or birth defects than anyone else. Your first and most important step is to seek medical and psychological help with your disorder, if you have not already done so.

Even if you feel your eating disorder is a thing of the past, keep in mind that physical and emotional changes during pregnancy can trigger depression and a relapse of an eating disorder. Don’t take it lightly. If you had an eating disorder in the past, talk to your doctor and consider visiting a therapist.

Follow some of these guidelines if you struggle with an eating disorder and want to become pregnant or have discovered that you are pregnant.

Before pregnancy, do the following:

• If you have an eating disorder and have not yet searched for professional help, that needs to be your first step—before you even begin to consider pregnancy.

• Achieve and maintain a normal and healthy weight.

• Consult with your doctor and receive a medical checkup. Ask about prenatal vitamins.

• Meet with a dietitian, and start a healthy pregnancy diet. Once you become pregnant, the baby will take from your own nutritional stores. If they are not built up, it could cause problems for both you and your baby.

• Continue any counseling, both individual and group, that you are involved with.

• If you have already gone through counseling, it would be a good idea to go back to your therapist to discuss concerns about body image that may surface during pregnancy.

• Seriously consider and discuss with your therapist the implications and complications of becoming pregnant before you have successfully recovered.

During pregnancy, do the following:

• Have a prenatal visit early in your pregnancy and discuss with your doctor your past and/or present struggles with eating disorders. The more honest you are with your doctor, the more he can help.

• Shoot to achieve an essential and healthy weight gain. The closer you are to a normal weight gain, the better chance of having a healthy baby.

• Continue to visit with a dietitian to receive instruction on eating a healthy diet, how many calories are necessary, and making the right choices. Seek out a dietitian with experience in eating disorders.

• Do whatever you can to normalize your eating and eliminate purging activities.

• Continue to seek counseling to address your eating disorder and any underlying concerns. A therapist can help you through the difficult times of your pregnancy when your body begins to change.

Just as important as before and during pregnancy is the care you continue to receive after your baby is born. Women with eating disorders are more susceptible to postpartum depression, so continue with your counseling. Eating disorder behaviors can also hinder your breastfeeding efforts, so don’t allow yourself to fall back into unhealthy pre-pregnancy habits.

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