Risks of Bulimia During Pregnancy

The risks of bulimia during pregnancy are clear. Women with bulimia can struggle with their eating disorder both during and after their pregnancy. They can give birth to underweight babies who have health issues throughout their lifespan.

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About 5% of pregnant women will experience an eating disorder, and many give birth to healthy babies.[1] But you’ll need extra help and support — both before and after your baby is born — to ensure your family stays healthy.

pregnant woman

Can Pregnancy Trigger or Worsen Your Bulimia?

Women with bulimia have a complicated relationship with body image, nutrition, and weight gain. Pregnancy can amplify all of these problems.

You will gain weight, your shape will change, and you may experience food cravings. Your bulimia can worsen during this unusual time.

Women with bulimia have an increased chance of using fertility treatments when compared to their peers.[2] Your pregnancy may not be a surprise to you. But even if you hoped to get pregnant, you might be surprised at how the journey changes you.

Sharing Your Body During Pregnancy

In a study of pregnant women with eating disorders, many reported feeling like they’re living in a body that no longer belongs to them.[3] You may have the following experiences:

Feel the baby moving
Have intense cravings for certain foods
Develop food aversions
Gain weight, even when you don’t want to

Any or all of these changes could cause stress, and bingeing may seem like a great way to cope.

pregnancy test

Changing Body Shape

Many women with bulimia are at a normal weight or underweight.

Your medical team may encourage you to gain weight during pregnancy, which can change your body shape and size. These adjustments can trigger your eating disorder.[4]

Poor Coping Skills

As your pregnancy continues and your shape changes, you may binge to cope with stress and lean on purging techniques to keep from additional weight gain. About 2.3% of pregnant women with bulimia use compensatory behaviors regularly to counteract their binges.[5]

Self-induced vomiting during pregnancy may seem familiar to you, but your habits could lead to fainting episodes. Both you and your baby could get hurt.

How Is Your Baby’s Health Impacted by Bulimia During Pregnancy?

During pregnancy, the foods you eat move from your body to your baby through the placenta. You share a circulatory system too. The choices you make have a direct impact on the health and viability of your baby.

Eating disorders during pregnancy are associated with the following:[6]

Delayed fetal growth
Low birthweight
Lung problems
Miscarriage
Premature birth
Stillbirth

Babies born small or too early can have problems throughout their lives. Infants with a low birth weight are more likely to develop high blood pressure and type 2 diabetes later in life.[7]

Your pregnancy is riskier too. Women with bulimia are more likely to develop complications like preeclampsia, and they might be forced to have a cesarean birth.[6] Either of these issues could also raise the risk of losing your baby.

pregnant woman

Limit the Impact of Being Bulimic & Pregnant

Clear, open communication with your medical team can ensure you have a healthy and successful pregnancy.

Tell your doctor about your bulimia, even if you’ve been in remission for years. Together, you can come up with a plan to keep you healthy.

Your team will also provide a meal plan to ensure you gain the right amount of weight.[8] It’s crucial to follow those guidelines carefully. Your baby likely needs you to gain weight during pregnancy. With help from your medical team, you can do this safely.

What Happens Next?

Many pregnant women focus exclusively on the immediate circumstances of pregnancy and childbirth. But for women with eating disorders, the challenges can continue after their baby is born.

Many women with eating disorders return to their pre-pregnancy thoughts and eating patterns after the birth of their baby.[9] And women with bulimia have greater weight losses after pregnancy than their peers.[10]

You may be tempted to restrict your diet until you get back to your pre-pregnancy weight. And your unrealistic expectations could cause so much stress that bingeing episodes begin.

You must stay involved with your treatment team after your baby is born. Get help with the fluctuating hormones and stresses associated with the postpartum period, and you’ll be healthy enough to care for your new baby. With assistance, you may find the challenges easier to handle.

Finding Professional Help & Support for Bulimia During Pregnancy

With professional help and assistance, healing from bulimia can take place, which increases the chances of a mother having a safe and healthy pregnancy. If you or someone you love is struggling with bulimia during pregnancy, it is important to seek out help and support as soon as possible.

If you are not sure where to begin to get help, start by having a discussion with your OB/GYN doctor or midwife.

Remember that bulimia is a disease that should be taken seriously. It is critical to have an honest conversation with your health care provider about your struggle. Your doctor may be able to point you to resources that can help support your recovery and your pregnancy.

References

New Tool Developed by WVU Researchers Makes It Easier to Identify Pregnant Patients with Eating Disorders. West Virginia University. https://wvutoday.wvu.edu/stories/2022/05/17/new-tool-developed-by-wvu-researchers-makes-it-easier-to-identify-pregnant-patients-with-eating-disorders. May 2022. Accessed July 2022.
Fertility Treatment, Twin Births, and Unplanned Pregnancies in Women with Eating Disorders: Findings From a Population-Based Birth Cohort. BJOG. https://pubmed.ncbi.nlm.nih.gov/24206173/. March 2014. Accessed July 2022.
Waking Up Every Day in a Body That Is Not Yours: A Qualitative Research Inquiry Into the Intersection Between Eating Disorders and Pregnancy. BMC Pregnancy and Childbirth. https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-018-2105-6. November 2018. Accessed July 2022.
Eating Disorders in Pregnancy. BMJ. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2190274/. January 2008. Accessed July 2022.
Recognizing the Symptoms: How Common Are Eating Disorders in Pregnancy? European Eating Disorders Review. https://onlinelibrary.wiley.com/doi/abs/10.1002/erv.2229. March 2013. Accessed July 2022.
Eating Disorders and Pregnancy. American Pregnancy Association. https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/eating-disorders-and-pregnancy/. Accessed July 2022.
The Effects of Eating Disorders in Pregnancy on Mother and Baby. Psychiatria Danubina. https://hrcak.srce.hr/file/383731. 2019. Accessed July 2022.
Eating Disorders and Pregnancy. March of Dimes. https://www.marchofdimes.org/complications/eating-disorders-and-pregnancy.aspx. April 2016. Accessed July 2022.
The Experience of Women With an Eating Disorder in the Perinatal Period: A Meta-Ethnographic Study. BMC Pregnancy and Childbirth. https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-018-1762-9. May 2018. Accessed July 2022.
Gestational and Postpartum Weight Change Patterns in Mothers with Eating Disorders. European Eating Disorders Review. https://pubmed.ncbi.nlm.nih.gov/25201473/. November 2014. Accessed July 2022.

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