Over my many years as a practicing obstetrician, I can say that one of the most commonly asked question is “How much weight should I gain?” Women are naturally concerned about their baby’s health, but many are concerned about the impact their pregnancy will have on their waistlines. It’s normal to wonder if a pregnancy will alter your looks permanently, but it is particularly problematic for women who suffer from eating disorders. Women with anorexia and bulimia nervosa because of their disease are acutely aware of changes in their bodies and may struggle with the normal and typical weight gain. Women of normal weight and body mass index (BMI) should gain between 25 to 35 pounds. However, women who are underweight should gain 28 to 40 pounds.
The medical literature regarding pregnancy and eating disorders is rather scant, but obstetricians are aware of the risks associated when a woman does not gain an appropriate amount of weight during pregnancy. These risks vary from patient to patient, but women who are underweight prior to conceiving and then fail to gain enough weight are at increased risk of having an infant with low birth weight and all the associated complications of low birth weight. These include respiratory problems, intraventricular hemorrhage or brain bleeds, heart problems, intestinal and eye damage. Some of these problems can cause lifelong disability or may even be fatal. Women who are bulimic may have infants who are overweight due to gestational diabetes.
Besides the health risk for the infants, mothers too are at risk of developing serious health problems. For instance, women with anorexia and bulimia may suffer from malnourishment, vitamin and mineral deficiency, dehydration, gestational diabetes, heart arrhythmia, depression, post-partum depression, and in extreme cases, death. Since the health risks are so great for both mother and baby, it is imperative that a pregnant woman with any eating disorder be candid and open about her problem. During the first trimester of pregnancy women are usually seen monthly to monitor their pregnancy. This physical includes a check of weight, blood pressure, and labs to make sure the mother’s and fetus’ health are in good order. Women with eating disorders will need to be followed more closely to ensure that there are able to maintain healthy eating habits during their pregnancy.
Women with anorexia and bulimia will need both psychological and nutritional counseling during their pregnancy to make sure they can eat healthfully and deal with the psychological stress of normal pregnancy weight gain. Many women with eating disorders can overcome their symptoms during pregnancy because of their strong desire for a healthy baby, but others will find pregnancy a very stressful adjustment. Women with eating disorders can achieve a healthy pregnancy and deliver a healthy happy baby if they remain diligent and get the necessary support they need. Of course, resolving an eating disorder before becoming pregnant is the best scenario, but is not always possible. Perhaps for some women with eating disorders, a pregnancy and all the potential it represents will be just the impetus they need to finally beat their disorder for good.
Dr. Hardy is the solo physician with Atlantic Ob/Gyn with locations in Va. Beach and Chesapeake. Call 757-463-1234 or 757-548-0044 or visit www.atlanticobgyn.com.