|
Eating
Disorders
The majority of
those who will develop an eating disorder are adolescent girls and
young women in their childbearing years. The presence of an eating
disorder often has negative health consequences that can make it
more difficult to become pregnant. If a young woman with an eating
disorder does become pregnant, her pregnancy may carry risks if
her health and nutritional status have suffered.
Women with eating
disorders may have higher rates of miscarriage, premature delivery,
and lower birth weight babies. Pregnancy can worsen cardiac, liver
or kidney damage a woman may already have developed as a result
of an eating disorder. Teeth and bones, already weakened by poor
nutrition, could become even more fragile.
The American
Psychiatric Association(APA) recognizes two major eating disorders:
anorexia nervosa and bulimia nervosa. The APA estimates that in
the United States at least 500,000 people are struggling with disordered
eating, and the numbers are increasing. Binge-eating is being looked
at as a related disorder.
Anorexia
Nervosa
Women
with a recent history of anorexia are likely to be underweight and
poorly nourished. This increases the risk of delivering a premature
or low birth weight baby. Having a higher pregnancy weight gain,
and eating adequately during pregnancy, can help reduce these risks.
You should probably be taking a prenatal vitamin/mineral supplement
and you may need extra iron and calcium during your pregnancy.
Anorexia
Nervosa is a disease characterized by self starvation. Clinical
diagnosis occurs when self-restricted dieting results in a body
weight that is less than or equal to 85 percent of normal for age
and height. Approximately one in one hundred girls (teens through
twenties) suffers with this serious disease. Health consequences
can be severe including amenorrhoea (a condition when menstruation
stops), anemia, and damage to major organs such as heart, liver
and kidneys. Without treatment, death can occur.
|
Typical
Symptoms Of Anorexia Nervosa
|
- Significant
weight loss
(15% or more below usual weight)
- Amenorrhoea
- Distorted
body image
- Fear
of becoming fat
- Constipation
- Difficulty
maintaining body temperature
- Fainting
- Excessive
exercise or hyperactivity
- Hair
loss
|
Treatment for
anorexia is twofold. The first is to address physical health and
restore body weight to a healthful range. Hospitalization is often
necessary if the body weight has dropped below 75% of normal. A
physician, nutritionist and psychologist often make up the health
care team.
The second part
of treatment focuses on preventing relapse and treating the psychological
issues associated with the disease. This may involve psychiatric
counseling for the anorexic and her family, medication, and ongoing
medical monitoring and nutrition counseling.
Bulimia
Nervosa
Bulimia nervosa is characterized by eating binges followed by
purging activities such as vomiting, laxative use or bouts of excessive
exercise. This disorder may be more prevalent among young women
than anorexia nervosa. Bulimia may be harder to detect than anorexia
because a normal weight may be maintained. Incidence is estimated
at 2 to 5 percent of teenage girls and young women.
|
Signs
Of Bulimia Nervosa
|
- Eating
binges
- Use
of the bathroom right after eating
- Damaged
teeth and gums
- Overuse
of laxatives or diuretics
- Swollen
salivary glands
- Excessive
concern about weight
- Compulsive
exercising
- Significant
weight fluctuations
|
Complications
of bulimia can be severe including damage to the esophagus, organ
damage and dehydration. Depletion of key minerals such as potassium
can occur from vomiting and laxative use. Vomiting,
laxative use, and other purging behaviors, have the potential to
disturb your body's electrolyte balance. This electrolyte imbalance
can have serious health consequences that impact your ability to
have a healthy pregnancy. Pregnancy is a time that all types of
purging behaviors should be avoided.
Treatment for
bulimia addresses the physical symptoms and the underlying psychological
issues. Antidepressants are sometimes used along with individual
or group counseling. A physician, therapist and a nutritionist can
all be integral parts of the treatment team.
Eating
Disorders and Weight Gain
Appropriate weight
gain and weight gain rate is important during pregnancy. If
you have an eating disorder, you may have issues with your
body image and be fearful of weight gain. It may help you to see
a therapist during pregnancy to discuss these feelings. Review your
weight gain with your provider at each prenatal visit. It may be
a good idea to meet with a registered dietitian to review your diet
for nutrient adequacy.
Can
Women With Eating Disorders Have a Successful Pregnancy?
Ideally,you should wait until you are fully recovered from an
eating disorder before becoming pregnant. You should talk to your
health care provider about your eating disorder history and any
health consequences you have suffered. By giving your health care
provider as much information as you can, you help ensure you get
the appropriate care for your pregnancy.
If you are planning
to become pregnant and you have a history of an eating disorder,
here are some things you can do to enhance your chances of having
a healthy pregnancy:
|
Pregnancy Guidelines For Women Or
Teens With Eating Disorders
|
-
Achieve and maintain a normal weight before pregnancy.
-
Avoid any purging activities, laxative or diuretic use.
-
Have a thorough medical check up.
-
-
Continue therapy and support group attendance.
-
Inform your prenatal care provider about your eating disorder
history.
|
|
