AL SHIFA CLINIC KARACHI

Syed Intisar Hussain

People suffer from different types of unhealthy eating disorders. Treatment of these eating disorders is critical, or it may harm your baby as well.

Eating Disorder | Effect on Baby | Treatment | Meri Sehat

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Will My Eating Disorder Affect My Baby?

Introduction

<a href="https://www.merisehat.pk/disease/bulimia-nervosa">Bulimia nervosa</a>, also called bulimia, is an eating disorder that affects up to 3% of women and more than 1% of men during their lifetime<a href="#accordion">[1]</a>. The psychiatric illness is characterized by uncontrollable binging episodes followed by purging behaviours such as vomiting, excessive exercising, or the use of laxatives. Although a combination of genetic, societal, and psychosocial factors is to blame for its development, media has played a huge role in causing eating disorders among teens and adults.&nbsp;

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Since the 1950s, the media&#39;s portrayal of beauty standards in women has significantly gone &#39;thin&#39;. Moreover, media&#39;s infiltration into our phones through social media apps&nbsp; has led to women worldwide developing body image issues. This is further exacerbated by celebrities subtly and not so subtly promoting diet culture. And since teens and young adults are the highest consumers of such media, it is not a surprise that fad diets and an obsession with the &#39;ideal body shape&#39; are increasing among the younger population. Approximately 4-38% of young adolescents in South Asian countries have a tendency toward eating disorders<a href="#accordion">[2]</a>.

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Bulimia often begins with excessive dieting that leads to a starvation mode. As a result, people binge on food with a lack of control. The resulting shame and guilt, coupled with a fear of weight gain, then causes people to practice various purging behaviours. Although it is common in young adolescents, the illness tends to persist well into adulthood. And in women, this can persist well into their pregnancy. A study from Brazil found that at least 7.6% of pregnant women suffer from some sort of eating disorde<a href="#accordion">r[3]</a>.

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Understanding the adverse effects of Bulimia on pregnancy

Bulimia is a highly complex condition and coupled with pregnancy the psychiatric illness can have several adverse effects on both the mother and the fetus. Moreover, the outcome of the pregnancy is highly dependent on the women&#39;s eating disorders. Research has shown that bulimia increases the risk of miscarriages, low birth weight, premature birth, fetal growth problems, and birth defects<a href="#accordion">[4]</a>. 
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Pregnancy requires an adequate intake of nutrition by the mother. However, women with bulimia have a fear of weight gain, and pregnancy which is associated with weight gain- can be a highly challenging period. Multiple factors contribute to causing a high-risk pregnancy in women suffering from bulimia. These include increased stress, malnutrition, comorbidities, psychological symptoms, relapse of the eating disorder, and much more<a href="#accordion">[5]</a>. Women who continue to binge and purge during pregnancy, have altered glucose levels, electrolyte imbalances, dehydration, and cardiac problems.&nbsp;

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Miscarriage is defined as the spontaneous loss of pregnancy before the 20th week of gestation. According to research, women with bulimia have a 2.6 times higher risk of miscarriage<a href="#accordion">[6]</a>. While the risk of preterm birth (baby born before the 37th week of pregnancy) is 3.3 times higher<a href="#accordion">[6]</a>. However, the effects of bulimia don&#39;t just stop here. Post-pregnancy complications such as postpartum depression have a higher incidence among bulimia sufferers. Moreover, babies born to mothers with bulimia also have poor outcomes. Along with low birth weight, these children had low Apgar scores at birth and higher chances of having microcephaly.&nbsp;

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Bearing all the aforementioned points in mind, there is a need for screening and early detection of bulimia nervosa in pregnant women.

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A multidisciplinary effort is required for the treatment of pregnant women with bulimia. A team consisting of nutritionists, mental health professionals, and physicians can help form healthy eating habits which can make pregnancy an easier period for the mother. And improve both maternal and fetal outcomes.&nbsp; 
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If you are someone who struggles with an eating disorder and are planning to become pregnant, it is best to first get treated for the illness and then focus on pregnancy.&nbsp;

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Conclusion

Eating disorders often go unnoticed in a community. This is mostly due to denial, or the shame associated with eating disorders. Women avoid seeking help which manifests in the development of life-threatening health consequences. Moreover, many develop mental health changes such as depression and anxiety. Thus, a women&#39;s overall quality of life is affected.&nbsp; 
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The high prevalence of unhealthy eating habits and poor body image has led to an increase in eating disorders among young adolescents. These habits are often propagated by the media promoting unhealthy beauty standards and diet culture among people. Although diets can help achieve good health, they should always be done with the help of professionals such as nutritionists and dieticians. 
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To counter the rise of eating disorders such as bulimia, it is important that young adolescents and adults are made aware of the psychiatric illness. Moreover, since media plays a huge role in causing such illnesses, it is important that children are exposed to more body positivity messages and healthy habits. 
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Key Points

<ul>
	<li>Bulimia nervosa is an eating disorder characterized by recurrent episodes of binging and purging. Although more common in adolescents, the illness often lingers into adulthood.</li>
	<li>Eating disorders such as bulimia affect 7.6% of pregnant women. These women have a higher risk of preterm birth, miscarriage, low birth weight, and birth defects.</li>
	<li>A multidisciplinary team consisting of nutritionists, obstetricians, mental health professionals, and physicians can help women form healthy eating habits and in turn have a successful pregnancy.&nbsp;</li>
	<li>If you suffer from an eating disorder, seeking professional help can improve both your and your child&#39;s overall health and help you achieve a healthy pregnancy.&nbsp;</li>
</ul>

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[1].Eeden, A. E. v., Hoeken, D. v. & Hoek, H. W., 2021. Incidence, prevalence and mortality of anorexia nervosa and bulimia nervosa. Current opinion in psychiatry, 34(6), pp. 515-524.

[2].Din, Z. u. et al., 2019. Tendency Towards Eating Disorders and Associated Sex-specific Risk Factors Among University Students. Noro psikiyatri arsivi, 56(4), pp. 258-263.

[3].Dos Santos, A. M. et al., 2017. Presence of eating disorders and its relationship to anxiety and depression in pregnant women. Midwifery, Volume 51

[4].Watson, H. J. et al., 2015. Psychosocial Factors Associated with Bulimia Nervosa during Pregnancy: An Internal Validation Study. The International Journal of Eating Disorders, 48(6), pp. 654-662.

[5].das Neves, M. d. C. et al., 2021. Eating disorders are associated with adverse obstetric and perinatal outcomes: a systematic review. Braz J Psychiatry, 44(2), pp. 201-214.

[6].Morgan, J. F., Lacey, J. H. & Chung, E., 2006. Risk of postnatal depression, miscarriage, and preterm birth in bulimia nervosa: retrospective controlled study. Psychosomatic medicine, 68(3), pp. 487-92.