Anorexia in pregnancy: risks and consequences

According to a scientific study from 2013  , around 1.1 percent of women in Germany suffer from anorexia, most of them under the age of 30. Anorexia – and the associated deprivation of important nutrients – affects the entire body and, in women, also the menstrual cycle. It is therefore often difficult for anorexics or women who once were to become pregnant.

Desire to have children with anorexia

In many cases, people with anorexia or women who have had an eating disorder for a long time miss their periods. The low body weight leads to hormonal imbalances. For example, the body is no longer able to produce enough female sex hormones, the so-called estrogens, which play an important role in ovulation . The fertilization of an egg cell and thus a pregnancy are not possible in such cases.

If you don’t have a period for more than three months, it’s called secondary amenorrhea . This clinical picture is a classic symptom of anorexia, for which being underweight is responsible.

Even if an affected person regains weight, it may take a while for regular bleeding to return. Anorexia or other eating disorders can therefore also impair conception in the medium to long term.

anorexia in pregnancy

Most women who suffer from anorexia during pregnancy have had the condition beforehand. However, the severity can worsen during pregnancy or anorexia can occur from scratch. An eating disorder in pregnant women is also known as “pregorexia” – a combination of the English words “pregnancy” (pregnancy) and “anorexia” (anorexia).

Since pregnancy means weight gain, affected mothers fear a loss of control due to the heavy weight gain, reduce their eating habits or do excessive sport, for example, to compensate for the natural development. The weight gain of a pregnant woman is absolutely necessary so that the baby can grow and develop healthily.

Many sufferers ignore the fact that the “pregnancy kilos” are not exclusively fat. You can see the changes that take place in the body here:

• The amniotic fluid that encloses your baby forms in the uterus . It can weigh up to 1 kg.
• Hormonal changes lead to water retention in the tissue of up to 3 kg.
• The uterus grows to 1 kg in weight to give your baby enough space
• The placenta , which supplies your baby with vital nutrients, weighs up to 500 g.
• The blood volume increases significantly because your body now has to supply two people. That means an additional 1-2 kg of weight.
• Mammary glands are increasingly forming in your breasts so that there is enough breast milk for your baby after birth . This development not only means that your breasts feel firmer, they also gain around 500 g in weight.
• Your body forms natural fat reserves of around 2 kg in order to have sufficient nutrient depots available.

Consequences for the child with anorexia

During pregnancy, mothers with eating disorders are not only responsible for their own bodies, but also for the nutritional needs of their growing baby. So if anorexia occurs during pregnancy, in most cases it will also affect the unborn baby.

Babies are completely dependent on their mother’s eating habits. This means that if the mother does without important nutrients, this also corresponds to the baby’s nutritional plan.

One of the most common effects of anorexia in pregnancy is severe underweight in the baby. This malnutrition, in turn, can lead to developmental delays, disabilities or susceptibility to diseases in the medium or long term. A higher death rate in the first year of life and, in the worst case, premature birth or miscarriage are also associated with anorexia during pregnancy.

Anorexia in pregnancy: consequences for the mother

In addition to the sometimes serious consequences for one’s own child, experts repeatedly emphasize that mothers-to-be in particular suffer great damage if they suffer from an eating disorder during pregnancy.

This can be explained by the fact that the placenta tries to supply the growing baby with nutrients as best it can. If the body does not get enough of this, the supply organ “serves” on the reserves of the female body.

These depots and “emergency resources” are thus depleted piece by piece, which can lead to a serious nutrient deficiency in the mother herself. A frequent consequence of this malnutrition is, for example, a lack of calcium in the pregnant woman, which can ultimately lead to osteoporosis, i.e. bone loss. This is particularly dangerous because the weakened bone structure can cause the pelvic bones to break during childbirth. For this reason, the baby of a pregnant anorexic is usually delivered by caesarean section . Spinal injuries are also possible.

Other consequences of anorexia during pregnancy are, for example, high blood pressure or other cardiovascular problems, which in the worst case can end in a heart attack. In addition, the resulting, persistent feeling of weakness causes many of those affected to feel overwhelmed, which can lead to the pregnant woman falling into depression – during or shortly after pregnancy.

Problems with breastfeeding can also arise as a result of anorexia, since the malnourished body does not have the necessary resources to produce sufficient breast milk.

Help for anorexic pregnant women

When expectant mothers are afflicted with anorexia, there are a few ways to help them and the unborn child:

• Seek an open conversation with a doctor/obstetrician who conducts frequent screening tests
• Working with a nutritionist to create a meal plan that can help manage weight after the baby is born
• mental health care
• A self-help group for exchange
• If necessary, a hospital stay

The most important thing in such a difficult situation is honest dealings with your partner and the rest of the family. An affected woman should not be alone in her situation, but should be supported. A joint visit to a doctor or psychologist is certainly a great help for the mother-to-be.