The School of Antenatal Educators


Eating in Pregnancy

"this is an article by Helen Gaynor "

When Eating Disorders Hamper the Joy of Pregnancy

For many women across the globe, pregnancy is one of the most joyful time of their lives: a time when they can concentrate on feeling fit and healthy, and prepare for the new arrival. For the seven million American women who struggle with an eating disorder, however, pregnancy can be anything but a happy time. These women may be used to consuming a very small number of calories, or to binging, or binging and purging. These habits may cause great harm to both mother and child, which is why eating disorders need to be diagnosed and treated promptly. In this post, we shall discuss common eating disorders and list down steps women can take to ensure a healthy pregnancy.

Pregnancy: A Time to Fuel Up

According to studies, pregnant women should aim to consume around 1,800 calories daily during the first trimester, 2,200 calories during the second trimester, and 2,400 calories during the final trimester. Women who are battling diseases like anorexia nervosa, however, in which extreme starvation and calorie counting is the norm, find it difficult to live up to these goals. Some women may find pregnancy a welcome break from calorie counting, but when they are used to struggling against their own body image, the changes that pregnancy produces can cause great angst in. Many can encounter depression and anxiety, or find it difficult to control their food consumption, gaining more weight than is necessary, or not gaining enough. Pregnancy forces them, as it were, to let go of the tight reins of control and eating disorders are closely linked with a need to control one’s own outcomes.

Health Risks of Eating Disorders During Pregnancy

When a woman fails to consume enough calories or engages in binging and purging behaviour (as is characteristic of bulimia nervosa), she can suffer from malnourishment, and her baby may not receive the nutrients it needs to develop properly. Those who have binge eating disorder, meanwhile, can gain an unhealthy amount of weight, due to the excess calories consumed. This can increase the risk of gestational diabetes and high blood pressure. Babies, too, suffer the effects of eating disorders. They can be born with a low birth weight, or have hampered brain development or respiratory distress syndrome.

Tips for Women with Eating Disorders

If you are pregnant and struggling against an eating disorder, tell your doctor about the problem. She will most probably refer you to other specialists, such as a good nutritionist, who can help draft a healthy eating plan to ensure your caloric intake and weight gain are kept within healthy limits. You may also be referred to a therapist, who can help you build a healthy relationship to food via therapies such as CBT (Cognitive Behavioural Therapy), group therapy, family therapy, etc.

One of the most successful current therapies is that of Maudsley Family Therapy, in which the whole family joins together to support the person with the eating disorder. The therapy begins from the premise that nobody is to blame; after all, there are many possible causes of eating disorders, some of which may be genetic.

Causes of Eating Disorders

In fact, studies have shown that specific complications experienced by a mother (including maternal anaemia, diabetes mellitus and placental infarction) can increase a child’s likelihood of developing anorexia nervosa later in life, as can neonatal heart issues. These studies indicate that specific obstetric complications can contribute to the development of eating disorders, by depriving a foetus of the oxygen and nutrients it need for proper development; some conditions can actually cause brain damage. The source of eating disorders is impossible to pinpoint and because they are so deadly (anorexia nervosa has an alarmingly high mortality rate), the focus should always be on the present and future, not the past.

The Importance of Therapy

The first step in Maudsley Therapy is to re-establish a healthy relationship to food. Little by little, the person with the eating disorder is given more autonomy in terms of selecting the foods they wish to eat and developing a suitable eating plan for life.

Women should receive help not only because their pregnancy or their baby’s health may be affected by their disorder, but also because they may have concurrent conditions (such as depression or anxiety) which also need to be separately diagnosed and treated. In most cases, therapy may be sufficient to quell these conditions, but in severe cases, medication may be necessary to ensure the health of mother and child.