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Eating disorders in pregnancy

Author
Scott J Crow, MD
Section Editors
Joel Yager, MD
Charles J Lockwood, MD, MHCM
Deputy Editor
David Solomon, MD

INTRODUCTION

Anorexia nervosa (table 1), bulimia nervosa (table 2), and binge eating disorder are characterized by persistent disturbances in eating patterns that impair general health and psychosocial functioning [1]. Eating disorders are most often found in adolescent and young adult women; thus, they often come to medical attention during pregnancy when weight and eating habits are closely monitored. For some women with eating disorders, pregnancy is an opportunity for recovery (comparable to stopping tobacco or alcohol use); for other patients, pregnancy is a period of vulnerability for onset, persistence, or relapse of eating disorder symptoms.

This topic reviews pregnancy, birth, and postpartum outcomes in the context of eating disorders; the course of eating disorders during and after pregnancy; and management of eating disorders that is specific to pregnant women. Diagnosis and treatment of eating disorders in the general population are discussed separately. (See "Eating disorders: Overview of epidemiology, clinical features, and diagnosis" and "Eating disorders: Overview of treatment".)

INITIAL ASSESSMENT

The initial clinical evaluation of patients with a possible diagnosis of anorexia nervosa, bulimia nervosa, or binge eating disorder includes a psychiatric and general medical history, mental status and physical examination, and focused laboratory tests [2,3]. The assessment can be difficult because women with eating disorders tend to conceal their abnormal eating patterns and compensatory behaviors (fasting, laxative abuse, diuretic abuse, purging, or excessive exercise) due to denial, shame, and/or guilt [4,5]. Screening may help detect eating disorders. (See "Eating disorders: Overview of epidemiology, clinical features, and diagnosis", section on 'Screening'.)

Warning signs that pregnant women may have an eating disorder include [4,6,7]:

History of an eating disorder

                      

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Literature review current through: Nov 2016. | This topic last updated: Tue Dec 22 00:00:00 GMT+00:00 2015.
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