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"Pregorexia" combines the words "pregnancy" and "anorexia" to describe women who are afraid of weight gain during pregnancy and who don't adequately nourish themselves and their developing baby. It's not an actual medical diagnosis – but it does describe some very real and concerning behavior.
It's almost taken as a compliment if you tell a pregnant woman, "Wow, you can hardly tell you're pregnant." Different women gain different amounts, and there's a healthy range of weight gain. Not gaining enough weight when you're pregnant is dangerous: It can increase the risk of miscarriage and birth complications such as prematurity and low birth weight.
If you restrict your food intake during pregnancy, your baby doesn't get adequate nutrients. And your baby needs so many nutrients for development in utero.
Restricting food when you're pregnant is contrary to biology. Women with anorexia are exerting enormous cognitive control over a natural biological drive, which is to eat during pregnancy.
We're not sure how many women suffer from eating disorders during pregnancy, but a large study in Norway found that 0.2 percent of women in early pregnancy had bulimia nervosa, 4.8 percent had binge eating disorder, and 0.1 percent had purging disorder. (There were no estimates for anorexia nervosa.)
All eating disorders during pregnancy are dangerous to both the mother and baby.
Binge eating disorder (BED) involves consuming excessive amounts of food, and it can lead to excess weight gain during pregnancy and high birth-weight babies. Women with BED tend to skip meals – especially breakfast – and have long intervals without food between binges. The disorder can expose fetuses to long periods without nutrients followed by sugar rushes.
Bulimia (binge eating followed by self-induced vomiting, excessive exercise, or laxative use) and purging disorder (self-induced vomiting or laxative abuse without binge eating) can deprive a baby of essential nutrients. Purging can also deplete a mom-to-be's electrolytes, which can be hazardous to both her and her baby.
As you might expect, women with a history of disordered eating are particularly at risk for eating disorders during pregnancy. This is especially true for first-time mothers, who aren't prepared for what is going to happen to their body. Some women think they will be fine when they get pregnant, but starting to gain weight can trigger a cascade of disordered thoughts and put them back in restriction mode.
Eating disorders can also strike expecting moms who haven't suffered from one in the past. Some of these women have kept a tight clampdown on weight and body size their whole life. When they start adding pounds during pregnancy, it throws them for a loop and they develop unhealthy behaviors with food.
Women often don't share a history of eating disorders with their obstetrician, and, frankly, most OBs don't know what to do if women reveal it. Most physicians still think eating disorders are a choice. We need to get women comfortable revealing them and we need to get physicians comfortable hearing about them so they can refer these women to dietitians, psychiatrists, and psychologists. These women need support from many different sources during pregnancy.
If you've suffered from an eating disorder, I suggest meeting with a psychologist and a dietitian to get a support team in place before you get pregnant, if possible. You can make important changes to improve the chances of a healthy pregnancy for you and your baby. For example, one study found that even when women with anorexia or a history of anorexia started pregnancy underweight, adequate weight gain during pregnancy protected against complications.
Despite the challenges that pregnancy can bring, many women with an eating disorder find it to be a turning point. At first they make positive changes for the health of their baby, but when these changes endure after pregnancy, through breastfeeding and beyond, they can mean a healthier future for both mother and baby.