Bulimia Increases Risk of Miscarriage, Premature Delivery

July 11, 2000 -- Women with bulimia nervosa are at higher risk for complications if they become pregnant, a study presented last week at the Royal College of Psychiatrists meeting in Edinburgh, Scotland, reveals. But pregnancy actually may be a good time to treat the eating disorder, experts say.

Bulimia typically involves cycles of binge eating and vomiting, laxative use, and/or excessive exercise.

"Women with active bulimia have higher rates of miscarriage and premature delivery than women who have had bulimia in the past, but aren't currently experiencing symptoms," John Morgan, MD, tells WebMD. "Since bulimia is the most common eating disorder, affecting roughly one in 20 women, this is a problem obstetricians and women themselves need to be more aware of." Morgan, the study's lead researcher, is a psychiatrist at St. George's Hospital Medical School in London.

However, there is a silver lining to the cloud of potential complications. "Previous research of ours suggests that by the third trimester of pregnancy, almost all women are virtually binge-free, so pregnancy is a window of opportunity to engage bulimic women in treatment," Morgan says. "Most women with bulimia will talk about their disorder with a health provider if they're asked the right questions, and they respond very well to treatment once they are identified."

Debra Franko, PhD, program director of the Eating Disorders Center at Harvard Medical School, concurs. "My clinical experience is that most women with bulimia shift their focus from themselves to their baby, and start engaging in healthier eating habits as a result," she tells WebMD. "However, afterward they may experience additional problems, so this may be a time to be very vigilant."

The study used a questionnaire to ask nearly 125 women who had active bulimia during their first pregnancy about their experience. The same questionnaire was administered to more than 80 women who had had bulimia in the past, but were not experiencing symptoms during their first pregnancy.

In addition to miscarriage and early delivery, women with active bulimia also appear to be at higher risk for developing diabetes during pregnancy and experiencing postpartum depression. More birth defects also were seen in the group with active symptoms.

"If women know they have bulimia, they should be told that their pregnancy is much more likely to be successful if they are not experiencing symptoms during it," says Mark Blais, PhD, assistant professor of psychiatry at Harvard Medical School. "Their obstetrician should be asking questions about weight loss or fluctuation during pregnancy as well."

Vital Information:

• Bulimia nervosa is the most common eating disorder, characterized by cycles of binge eating and vomiting, laxative use, and/or excessive exercise.
• In a new study, pregnant women who currently are experiencing symptoms of bulimia are more likely to have complications, including miscarriage, early delivery, diabetes, and postpartum depression, compared to those who had bulimia in the past.
• Women with bulimia often begin healthier eating habits when they become pregnant, says one expert, because they shift their focus to their baby, so pregnancy is a good opportunity to treat these women.