The findings contradict the conventional wisdom that all women with eating disorders can take advantage of pregnancy as a time to recover, Dr Cynthia M. Bulik of the University of North Carolina at Chapel Hill, the study's lead author, told Reuters Health. "Basically it's important to know that it's not an automatic recovery mode. It doesn't mean that the minute you get pregnant, your eating disorder is going to go away."
The findings also underscore the importance of screening pregnant women for symptoms of eating disorders, which can lead to worse pregnancy outcomes for both mother and child, Bulik and her colleagues point out. "More often than not women don't disclose this to their obstetricians and their midwives," she noted.
Screen for eating disorders
Bulik and her team looked at 41 157 pregnant women participating in the Norwegian Mother and Child Cohort Study.
Before pregnancy, 0.1 percent of women had anorexia nervosa, 0.7 percent had bulimia nervosa, 3.5 percent had binge eating disorder, and 0.1 percent purged without bingeing.
Binge eating disorder is defined as eating an unusually large amount of food and feeling out of control, and should be distinguished from the normal increase in appetite that occurs in pregnancy, Bulik explained. People with the condition do not make themselves vomit or engage in other purging behaviors.
Among women who purged without bingeing before pregnancy, 78 percent stopped doing so while pregnant, the researchers found. Thirty-nine percent of women with binge eating disorder recovered during pregnancy, as did 34 percent of those with bulimia nervosa.
Pregnancy can spur binge eating
While it was rare for women to develop a purging disorder or bulimia nervosa for the first time while pregnant, 711 women in the study did develop binge eating disorder for the first time. Women with a higher body weight, less education and lower income were more likely to begin bingeing, as were those who smoked cigarettes, had more previous pregnancies, and had had at least one previous abortion.
"Pregnancy is a stressful time both biologically and psychologically," Bulik said. "It's possible that these women just didn't have the same kind of support systems and resources and for that reason pregnancy was more of a trigger for binge eating. Other people who might have a more 'padded' support system might be less prone to stress-induced symptoms," she added. - (Anne Harding/Reuters Health)
SOURCE: Psychological Medicine, August 2007.