Bulimia and pregnancy

The Norwegian Institute of Health issued a recent news release titled "Pregnant women with bulimia have more anxiety and depression". Much of that news release is repeated here.

What is Bulimia?
Bulimia (bulimia nervosa) is episodes of binge eating combined with various behaviours to compensate for the large intake of food and to avoid weight gain. These behaviours include vomiting, use of laxatives, periods of fasting or training. Vomiting leads to disturbances in the body’s salt balance and enamel erosion of teeth. People with bulimia are often of normal weight or overweight. Approximately 30 percent of persons with bulimia have a history of anorexia. Eating disorders affect both young and old but often occur for the first time in adolescence. Anorexia nervosa and bulimia are about ten times more common among women than men.

Who were the women in the study?
Out of more than 41,000 pregnant Norwegian women, 96 (0.2 %) met the criteria for broadly defined bulimia (bulimia nervosa) in the first trimester of pregnancy. 67 (0.16%) of the women reported that they had also had bulimia six months before pregnancy, while 26 (0.06%) had developed bulimia after becoming pregnant. It is unknown whether these women had bulimia earlier in life.

What did the study show?
Women who have bulimia in pregnancy have more symptoms of anxiety and depression compared to pregnant women without eating disorders.

They also have lower self-esteem and are more dissatisfied with life and their relationship with their partner.

Women with bulimia reported a higher prevalence of life-long physical abuse, sexual abuse and major depression compared with others, says Cecilie Knoph Berg at the Division of Mental Health at the NIPH.

Women who had bulimia six months before pregnancy but who were symptom-free in the first trimester, experienced higher self-esteem and satisfaction with life compared to other women with persistent symptoms.

According to the American Pregnancy Association, bulimia in pregnancy can have serious consequences for both mother and child:

• Premature labor (labor before the 37th week of pregnancy)
• Low birth weight (baby weighing less than 5.5 pounds)
• Stillbirth or fetal death (preborn baby dies in the womb after the 20th week of pregnancy)
• Likelihood of Cesarean birth
• Delayed fetal growth
• Respiratory problems
• Gestational diabetes
• Complications during labor
• Depression
• Miscarriage (preborn baby dies in the womb before the 20th week of pregnancy)
• Preeclampsia (high blood pressure during pregnancy)

Talk to your pregnant daughter about her eating habits before pregnancy and now that she is pregnant. Has she often eaten a lot of food, and then purged in some manner? If so, what methods did she use to purge the food? How often has she done this? Does she still have this habit now that she is pregnant?

If your pregnant daughter may have an eating disorder, she needs professional medical help as soon as possible. Her own physical and mental health depend on her getting help. And the physical health of your grandchild, her child, depend on her getting help.