How to Deal With Anorexia (Eating Disorder) During Pregnancy?

Researchers have developed recommendations and principles for multidisciplinary management of anorexia nervosa (eating disorder) in pregnancy.

Pregnant women with anorexia are at greater risk of having a stillbirth, underweight baby, or pre-term birth, yet there are no clear guidelines to manage the condition, according to a Monash University-led study.

Anorexia nervosa has an increased prevalence in women across childbearing years, with up to one in 200 pregnant women with the condition. It is typically associated with restricting or binging and purging behaviors, or both.

Anorexia Nervosa - Types Complications Causes Treatment FAQs
Anorexia nervosa is an eating disorder most commonly found among teenage girls. Anorexia nervosa is characterized by a very low body weight, generally defined as 15% below the Body Mass Index.

‘The assessment and monitoring of measures and tools for anorexia nervosa require modification in the context of pregnancy.’

“Unlike mood disorders and anxiety and psychotic disorders, little guidance and research are available for anorexia nervosa in pregnancy. Perinatal mental health guidelines, including those in the UK and Australia, provide only limited or no mention of the assessment and management of eating disorders in pregnancy,” said Professor Megan Galbally, Director of the Centre for Women’s and Children’s Mental Health at Monash University’s School of Clinical Sciences, in Melbourne, Australia.

Assessment measures used outside of pregnancy, such as the Eating Disorder Inventory, or the reliance on body mass index, have been shown to have limited validity in pregnancy.

Research into managing the health of pregnant women, in general, has highlighted the importance of maternal antenatal nutrition, pregnancy weight gain, and the infant’s birth weight as critical risk factors and vital intervention points for improving lifelong health including for areas such as heart disease, diabetes, and obesity.

All You Need to Know about Eating Disorders
Eating disorders involve extreme attitudes and behaviors towards food and weight. It has the highest suicidal mortality rate than other mental illnesses.

According to the study authors, anorexia nervosa might affect obstetric and neonatal outcomes through the low-calorie intake, nutritional and vitamin deficiencies, stress, fasting, low body mass, and problems with the function of the placenta.

Additionally, risks from untreated or undertreated anorexia nervosa in pregnancy include psychological and psychosocial risks, including perinatal depression and anxiety.

Eating Disorder Treatment Should Consider Cultural Aspects
The connection between eating disorders and cultural expectations surrounding femininity is left unnoticed in treatment for eating disorder.

The management of anorexia nervosa requires a multidisciplinary team approach with expertise across mental health, specialist medical care, and dietetics at a minimum.

The key experts include obstetricians (particularly experts who manage high-risk pregnancies), physicians with pregnancy expertise, dieticians who also have expertise in pregnancy nutrition requirements, pediatricians, and mental health clinicians with perinatal expertise.

Deep Brain Stimulation Helps Improve Treatment-resistant Anorexia
Anorexia, one of the fatal eating disorders can now be treated with deep vein stimulation that reduces the symptoms of anxiety and helps in weight gain.

Although many of the principles developed for the management of anorexia nervosa in adults are applicable in pregnancy, they require expert modification and adaptation to the substantial physiological, psychological, and social changes in pregnancy, and fetal growth and wellbeing should also be taken into consideration.

Source-Medindia