By Alex Young Nutrition Student
Pregnancy is a life-changing event and for those struggling with eating disorders, this journey may come with its own unique set of challenges. Balancing the nutritional needs of both the mother and the developing baby can be complicated for individuals with an eating disorders and those who are susceptible to relapse. Throughout this blog, we will explore the impact of eating disorders during pregnancy and offer guidance on how to manage this complex journey.
Understanding Eating Disorders
Before diving into the specifics of pregnancy, let's first understand what eating disorders are. Eating disorders are mental health conditions characterized by the use of controlling eating habits, distorted body image, an obsession with weight and/or food. People of all ages, ethnic backgrounds, body types, and genders can suffer from eating disorders.
· Anorexia nervosa (AN) is a condition in which people avoid food, severely restrict food, or eat only small amounts of specific foods. They may also weigh themselves several times. Even if they are critically underweight, they may perceive themselves to be overweight.
· Bulimia nervosa (BN) is a disorder in which patients have recurring periods of eating unusually large amounts of food and feeling out of control of their eating. This binge eating is followed by compensatory behaviours such as forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviours.
· Binge eating disorder (BED) is a condition in which people lose control of their eating and experience recurring periods of consuming abnormally large amounts of food. In contrast to bulimia nervosa, binge eating is not followed by purging, extreme activity, or fasting.
There is a common misconception that eating disorders are a lifestyle choice. In reality, eating disorders are severe and often fatal illnesses that are linked to substantial abnormalities surrounding a person's mental health which then links to poor eating behaviour.
The Impact of Eating Disorders on Pregnancy
The physical, emotional and psychological impact throughout the process of pregnancy can be a very challenging time, combine this effort with an eating disorder and this may have a significant effect on both mother and baby. Previous engagement in disordered eating behaviours may also trigger a relapse, by seeking the assistance of healthcare professionals could be essential support for coping with the strains of pregnancy and an eating disorder.
Risks to Mother
For mothers with active or previous eating disorders, there are various physical and psychological risks associated with pregnancy:
· Nutritional deficiencies: eating disorders can result in insufficient intake of essential nutrients, including vitamins and minerals, which are fundamental for a healthy pregnancy. Micronutrients such as folate, vitamin A, B6 and B12 are crucial for avoiding neural tube defects (NTDs) (Cetin et al, 2010)
· Complications during childbirth: Women with eating disorders may experience a great risk of health problems such as labour and delivery complications (prolonged labour, higher risk of caesarean delivery), premature birth and low birth weight (Watson et al, 2017)
· Postpartum depression: eating disorders can increase the risk of postpartum depression, which can have detrimental effects on both the mother and the baby's well-being (Ward, 2008)
· Relapse of Eating Disorders: although symptoms tend to be reduced during pregnancy, likely due to an increased sense of care for the baby, however postpartum can be a vulnerable time and often cause a previous ED to become exacerbated through increased anxiety, stress of taking care of baby and postpartum body shape frustration causing a relapse (Sebastiani et al, 2020)
Risks to Baby
Unaddressed eating disorders during pregnancy can also have serious consequences for the baby:
· Intrauterine growth restriction: Insufficient maternal nutrition due to eating disorders can lead to poor foetal growth, resulting in a low birth weight baby (Sebastiani et al, 2020)
· Birth defects: Certain nutritional deficiencies associated with eating disorders can increase the risk of birth defects in the baby, including lower birth weight, smaller head circumference and early neurobehavioral dysregulations (Dörsam et al, 2019)
· Developmental issues: Studies suggest that infants born to mothers with eating disorders may be at a higher risk of developmental problems including cognitive, social and emotional disturbances in the long term (Martini et al, 2020)
How to Support Yourself During an Eating Disorder Throughout Pregnancy
It's important for pregnant individuals with eating disorders to seek professional help to ensure a healthy pregnancy. Here are some approaches to consider:
· Establish a support network: Surround yourself with a team of healthcare professionals, including doctors, dietitians, and mental health specialists who specialize in treating eating disorders during pregnancy.
· Nutritional guidance: Work closely with a registered dietitian experienced in support people with eating disorders and pregnancy to create a balanced eating plan that meets both your nutritional needs and the baby's requirements. (National Institute of Mental Health, 2023).
· Therapy and counselling: Engage in regular therapy sessions to address the psychological and emotional aspects of your eating disorder. Cognitive-behavioural therapy (CBT) is one therapy that can be particularly effective in helping you develop healthier beliefs and behaviours.
· Self-care practices: Incorporate self-care activities into your routine to manage stress and promote overall well-being. This could include gentle exercise, mindfulness, journaling, or engaging in hobbies you enjoy.
· Open communication: Maintain open and honest communication with your healthcare provider, partner, and loved ones about your struggles, concerns, and achievements throughout your pregnancy journey.
Pregnancy whilst recovering from an eating disorder can be a challenging and an emotionally complex journey. Nonetheless, with support from healthcare professionals, and self-care practices, it is possible to navigate these difficulties and strive for a healthy and fulfilling pregnancy and beyond. Seeking help is a sign of strength and you deserve the support necessary to create a safe and nourishing environment for both you and your baby.
Guidance & Support
For more guidance on matters relating to pregnancy and the challenges surrounding eating disorders there are several organisations you can contact for free support;
Eating Disorders and Pregnancy
BEAT
EnglandHelpline: 0808 801 0677Email: help@beateatingdisorders.org.uk
ScotlandHelpline: 0808 801 0432Email: Scotlandhelp@beateatingdisorders.org.uk
WalesHelpline: 0808 801 0433Email: Waleshelp@beateatingdisorders.org.uk
Northern IrelandHelpline: 0808 801 0434Email: NIhelp@beateatingdisorders.org.uk
Tommy’s Together
Speak to a midwife
Call: 0800 014 7800
E-mail: midwife@tommys.org
References
BEAT eating disorders (2023). Learn about Eating Disorders. [online] Beat. Available at: https://www.beateatingdisorders.org.uk/.
Eating Disorders and Pregnancy (2023). Eating Disorders and Pregnancy. [online] www.eatingdisordersandpregnancy.co.uk. Available at: https://www.eatingdisordersandpregnancy.co.uk/useful-websites-2/
Cetin, I., Berti, C. and Calabrese, S. (2009). Role of micronutrients in the periconceptional period. Human Reproduction Update, 16(1), pp.80–95. doi:https://doi.org/10.1093/humupd/dmp025.
Dörsam, A.F., Preißl, H., Micali, N., Lörcher, S.B., Zipfel, S. and Giel, K.E. (2019). The Impact of Maternal Eating Disorders on Dietary Intake and Eating Patterns during Pregnancy: A Systematic Review. Nutrients, [online] 11(4), p.840. doi:https://doi.org/10.3390/nu11040840.
Martini, M.G., Barona-Martinez, M. and Micali, N. (2020). Eating Disorders Mothers and Their children: a Systematic Review of the Literature. Archives of Women’s Mental Health, 23, pp.449–467. doi:https://doi.org/10.1007/s00737-020-01019-x.
National Institute of Mental Health (2023). Eating Disorders. [online] www.nimh.nih.gov. Available at: https://www.nimh.nih.gov/health/topics/eating-disorders.
Sebastiani, G., Andreu-Fernández, V., Herranz Barbero, A., Aldecoa-Bilbao, V., Miracle, X., Meler Barrabes, E., Balada Ibañez, A., Astals-Vizcaino, M., Ferrero-Martínez, S., Gómez-Roig, M.D. and García-Algar, O. (2020). Eating Disorders During Gestation: Implications for Mother’s Health, Fetal Outcomes, and Epigenetic Changes. Frontiers in Pediatrics, 8. doi:https://doi.org/10.3389/fped.2020.00587.
Tommy's (n.d.). Eating Disorders in Pregnancy. [online] www.tommys.org. Available at: https://www.tommys.org/pregnancy-information/im-pregnant/mental-wellbeing/eating-disorders.
Ward, V.B. (2008). Eating Disorders in Pregnancy. BMJ, [online] 336(7635), pp.93–96. doi:https://doi.org/10.1136/bmj.39393.689595.be.
Watson, H.J., Zerwas, S., Torgersen, L., Gustavson, K., Diemer, E.W., Knudsen, G.P., Reichborn-Kjennerud, T. and Bulik, C.M. (2017). Maternal eating disorders and perinatal outcomes: A three-generation study in the Norwegian Mother and Child Cohort Study. Journal of Abnormal Psychology, 126(5), pp.552–564. doi:https://doi.org/10.1037/abn0000241.