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Eating Disorders in Pregnancy and the Postpartum

Empirically Informed Treatment Guidelines

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Psychiatric Disorders in Pregnancy and the Postpartum

Part of the book series: Current Clinical Practice ((CCP))

Abstract

Eating disorders are most often diagnosed during the childbearing years. Pregnancy and postpartum issues for women with eating disorders are discussed with regard to symptoms, complications, course of pregnancy, delivery, breast-feeding, and postpartum depression (PPD). Research findings indicate that women with eating disorders during pregnancy may be at risk for a variety of pregnancy and obstetric complications. Moreover, there appears to be an association between eating-disorder symptoms and low birthweight as well as premature delivery. PPD is higher in women with eating disorders, and feeding issues have been documented. Assessment and treatment guidelines are presented to assist health care providers in caring for pregnant patients with eating disorders.

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References

  1. American Psychiatric Association. (1994) Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: APA Press

    Google Scholar 

  2. Fairburn, C. G. and Harrison, P. J. (2003) Eating disorders. Lancet 361, 407–416.

    Article  PubMed  Google Scholar 

  3. Milner, G. and O’Leary, M. M. (1988) Anorexia nervosa occurring in pregnancy. Acta Psychiatr. Scand. 77, 491–492.

    Article  PubMed  CAS  Google Scholar 

  4. Willis, D. C. and Rand, C. S. W. (1988) Pregnancy in bulimic women. Obstet. Gynecol. 71, 708–710.

    PubMed  CAS  Google Scholar 

  5. Lacey, J. H. and Smith, G. (1987) Bulimia nervosa: the impact on mother and baby. Br. J. Psych. 150, 777–781.

    Article  CAS  Google Scholar 

  6. Blais, M. A., Becker, A. E., Burwell, R. A., et al. (2000) Pregnancy: outcome and impact in a cohort of eating disordered women. Int. J. Eat. Disord. 27, 140–149.

    Article  PubMed  CAS  Google Scholar 

  7. Morgan, J. F., Lacey, J. H., and Sedgwick, P. M. (1999) Impact of pregnancy on bulimia nervosa. Br. J. Psych. 174, 135–140.

    CAS  Google Scholar 

  8. Conrad, R., Schablewski, J., Schilling, G., and Liedtke, R. (2003) Worsening of symptoms of bulimia nervosa during pregnancy. Psychosomatics 44, 76–78.

    Article  PubMed  Google Scholar 

  9. Mitchell, J. E., Seim, H. C., Glotter, D., Soll, E. A., and Pyle, R. L. (1991) A retrospective study of pregnancy in bulimia nervosa. Int. J. Eat. Disord. 10, 209–214.

    Article  Google Scholar 

  10. Lemberg, R. and Phillips, J. (1989) The impact of pregnancy on anorexia nervosa and bulimia. Int. J. Eat. Disord. 8, 285–295.

    Article  Google Scholar 

  11. Brinch, M., Isager, T., and Tolstrup, K. (1988) Anorexia nervosa and motherhood: Reproduction pattern and mothering behavior of 50 women. Acta Psychiatr. Scand. 77, 98–104

    Article  Google Scholar 

  12. Bulik, C. M., Sullivan, P. F., Fear, J. L., Pickering, A., Dawn, A., and McCullin, M. (1999) Fertility and reproduction in women with anorexia nervosa: a controlled study. J. Clin. Psych. 60, 130–135.

    CAS  Google Scholar 

  13. Mitchell-Gieleghem, A., Mittelstaedt, M. E., and Bulik, C. M. (2002) Eating disorders and childbearing: concealment and consequences. Birth 29, 182–191.

    Article  PubMed  Google Scholar 

  14. James, D. C. (2001) Eating disorders, fertility, and pregnancy: relationships and complications. J. Perinat. Neonatal Nurs. 15, 36–48.

    PubMed  CAS  Google Scholar 

  15. Feingold, M., Kaminer, Y., Lyons, K., Chaudhury, A., Costigan, K., and Cetrulo, C. (1988) Bulimia nervosa in pregnancy: a case report. Obstet. Gynecol. 71, 1025–1027.

    PubMed  CAS  Google Scholar 

  16. Stewart, D. E., Raskin, J., Garfinkel, P. E., MacDonald, O. L., and Robinson, G. E. (1987) Anorexia nervosa, bulimia, and pregnancy. Am. J. Obstet. Gynecol. 157, 1194–1198.

    PubMed  CAS  Google Scholar 

  17. Abraham, S. (1998) Sexuality and reproduction in bulimia nervosa patients over 10 years. J. Psychosom. Res. 44, 491–502.

    Article  PubMed  CAS  Google Scholar 

  18. Stewart, D. E. (1992) Reproductive functions in eating disorders. Ann. Med. 24, 287–291.

    Article  PubMed  CAS  Google Scholar 

  19. Muscati, S. K., Gray-Donald, K., and Koski, K. G. (1996) Timing of weight gain during pregnancy: promoting fetal growth and minimizing maternal weight retention. Int. J. Obes. Relat. Metab. Disord. 20, 526–532.

    PubMed  CAS  Google Scholar 

  20. Sollid, C. P., Wisborg, K., Hjort, J., and Secher, N. J. (2004) Eating disorder that was diagnosed before pregnancy and pregnancy outcome. Am. J. Obstet. Gynecol. 190, 206–210.

    Article  PubMed  Google Scholar 

  21. Conti, J., Abraham, S., and Taylor. A. (1998) Eating behavior and pregnancy outcome. J. Psychosom. Res. 44, 465–477.

    Article  PubMed  CAS  Google Scholar 

  22. Franko, D. F., Blais, M. A., Becker, A. E., et al. (2001) Pregnancy complications and neonatal outcome in eating disordered women. Am. J. Psych. 158, 1461–1466.

    Article  CAS  Google Scholar 

  23. King, M. B. (1991) The natural history of eating pathology in attenders to primary medical care. Int. J. Eat. Disord. 10, 379–387.

    Article  Google Scholar 

  24. Stewart, D. E., Robinson, E., Goldbloom, D. S., and Wright, C. (1990) Infertility and eating disorders. Am. J. Obstet. Gynecol. 163, 2196–2199.

    Google Scholar 

  25. Martin, J.R. and Wollitzer, A. O.( 1988) The prevalence, secrecy, and psychology of purging in a family practice setting. Int. J. Eat. Disord. 7, 515–519.

    Article  Google Scholar 

  26. Becker, A. E., Grinspoon, S. K., Klibanski, A., and Herzog, D. B. (1999) Eating disorders. N. Engl. J. Med. 340, 1092–1098.

    Article  PubMed  CAS  Google Scholar 

  27. Becker, A. E., Franko, D. L., Nussbaum, K., and Herzog, D. B. (2003) Secondary prevention for eating disorders. Int. J. Eat. Disord. 35, 179–189.

    Google Scholar 

  28. Hollifield, J. and Hobdy, J. (1990) The course of pregnancy complicated by bulimia. Psychotherapy 27, 249–255.

    Google Scholar 

  29. Franko, D. L. and Spurrell, E. B. (2000) Detection and management of eating disorders during pregnancy. Obstet. Gynecol. 95, 942–946.

    Article  PubMed  CAS  Google Scholar 

  30. Lingam, R. and McCluskey, S. (1996) Eating disorders associated with hyperemesis gravidarum. J. Psychosom. Res. 40, 231–234.

    Article  PubMed  CAS  Google Scholar 

  31. Freund, K. M., Graham, S. M., Lesky, L. G., and Moskowitz, M. A. (1993) Detection of bulimia in a primary care setting. J. Gen. Intern. Med. 8, 236–242.

    Article  PubMed  CAS  Google Scholar 

  32. Mintz, L. B., O’Halloran, S. M., Mulholland, A. M., and Schneider, P. A. (1997) Questionnaire for eating disorder diagnoses: reliability and validity of operation-alizing DSM-IV criteria into a self-report format. J. Counsel. Psych. 44, 63–79.

    Article  Google Scholar 

  33. Fairburn, C. G., and Cooper, Z. (1993) The Eating Disorder Examination, 12th ed. In: Fairburn, C.G. and Wilson, G.T., eds. Binge Eating: Nature, Assessment, and Treatment. New York: Guilford Press.

    Google Scholar 

  34. Williamson, D. A., Anderson, D. A., Jackman, L. P., and Jackson, S. R. (1995) Assessment of eating disordered thoughts, feelings, and behaviors. In: Allison, D. B., ed. Handbookof Assessment Methods for Eating Behaviors and Weight Related Problems: Measures, Theory and Research, pp. 347–386.

    Google Scholar 

  35. American Psychiatric Association Work Group on Eating Disorders (2000) Practice guidelines for the treatment of patients with eating disorders (revision). Am. J. Psych. 157 (1 Suppl.), 1–39.

    Google Scholar 

  36. Knapp, C. (2003) Appetites. New York: Counterpoint Press.

    Google Scholar 

  37. Woodside D. B., Lackstrom, J. B., and Shekter-Wolfson, L. (2000) Marriage in eating disorders: comparisons between patients and spouses and changes over the course of treatment. J. Psychosom. Res. 49, 165–168.

    Article  PubMed  CAS  Google Scholar 

  38. Ward, E. M. (1998) Pregnancy Nutrition: Good Health for You and Your Baby. New York: Wiley.

    Google Scholar 

  39. Nilsson, L. (2003) A Child Is Born (4th ed.). New York: Delacorte Press.

    Google Scholar 

  40. Franko, D. L. and Hilsinger, E. (1995) Depression and bulimia in a pregnant woman. Harv. Rev. Psych. 2, 282–287.

    Article  CAS  Google Scholar 

  41. Gotlib, I. H. (1998) Postpartum depression. In: Blechman, E. A.and Brownell, K. D., eds. Behavioral Medicine and Women: A Comprehensive Handbook. New York: Guilford Press, pp. 489–494.

    Google Scholar 

  42. Abraham, S., Taylor, A., and Conti, J. (2001) Postnatal depression, eating, exercise, and vomiting before and during pregnancy. Int. J. Eat. Disord. 29, 482–487.

    Article  PubMed  CAS  Google Scholar 

  43. Wonderlich, S. A.and Mitchell, J. E. (1997) Eating disorders and comorbidity: empirical, conceptual, and clinical implications. Eat. Disord. Res. 33, 381–388.

    CAS  Google Scholar 

  44. O’Hara, M. W., Schlechte, J. A., Lewis, D. A., and Wright, E. J. (1991) Prospective study of postpartum blues: Biologic and psychosocial factors. Arch. Gen. Psych. 48, 801–806.

    CAS  Google Scholar 

  45. Agras, S., Hammer, L., and McNicholas, F. (1999) A prospective study of the influence of eating-disordered mothers on their children. Int. J. Eat. Disord. 25, 253–262.

    Article  PubMed  CAS  Google Scholar 

  46. Evans, J. and le Grange, D. (1995) Body size and parenting in eating disorders: A comparative study of the attitudes of mothers towards their children. Int. J. Eat. Disord. 18, 39–48.

    Article  PubMed  CAS  Google Scholar 

  47. Stein, A., Woolley, H., Cooper, S. D., and Fairburn, C. G. (1994) An observational study of mothers with eating disorders and their infants. J. Child Psychol. Psych. 35, 733–748.

    Article  CAS  Google Scholar 

  48. Stein, A., Murray, L, Cooper, P., and Fairburn, C. G. (1996) Infant growth in the contextof maternal eating disorders andmaternal depression: acomparative study. Psych. Med. 26, 569–574.

    CAS  Google Scholar 

  49. Stein, A., Woolley, H., and McPherson, K. (1999). Conflict between mothers with eating disorders and their infants during mealtimes. Br. J. Psych. 175, 455–461.

    Article  CAS  Google Scholar 

  50. Stice, E., Agras, W. S., and Hammer, L. (1999) Risk factors for the emergence of childhood eating disturbances: a five-year prospective study. Int. J. Eat. Disord. 25, 375–387.

    Article  PubMed  CAS  Google Scholar 

  51. Waugh, E. and Bulik, C.M. (1999) Offspring of women with eating disorders. Int. J. Eat. Disord. 25, 123–133.

    Article  PubMed  CAS  Google Scholar 

  52. Park, R. J., Senior, R., and Stein, A. (2003) The offspring of mothers with eating disorders. Eur. Child Adolesc. Psych. 12 (Suppl. 1), i110–i119.

    Google Scholar 

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© 2006 Humana Press Inc., Totowa, NJ

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Franko, D.L. (2006). Eating Disorders in Pregnancy and the Postpartum. In: Hendrick, V. (eds) Psychiatric Disorders in Pregnancy and the Postpartum. Current Clinical Practice. Humana Press. https://doi.org/10.1007/978-1-59745-013-3_8

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  • DOI: https://doi.org/10.1007/978-1-59745-013-3_8

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-486-9

  • Online ISBN: 978-1-59745-013-3

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