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.
