The impact of pregnancy on anorexia nervosa and bulimia

Abstract

The present study examines the impact of pregnancy on anorexia nervosa and bulimia. A survey of women with an active eating disorder involving anorexia nervosa, bulimia, or mixed symptoms 6 months prior to their first pregnancy was undertaken to gain information on attitudes toward becoming pregnancy, fears and concerns related to the unborn child, the impact on eating disorder behaviors prenatal and postnatal, weight gain and weight gain of the baby as an indicator of its health, and the obstetricians view of the pregnancy and health status of the infant upon delivery. The results indicate that pregnancy had a pronounced beneficial impact on anorexic and bulimic symptoms during pregnancy. However, lasting psychological benefit was limited to a minority of the sample in the first year after childbirth. In contrast to previous research, infants had normal birth weights and deliveries with an absence of congenital defects. The implications of these results and suggestions for future research are discussed.

Perturbações do comportamento alimentar na gravidez: uma revisão

“…Estudos demonstraram que a gravidez pode, por um lado, agravar, manter, reduzir, despoletar recaídas, ou mesmo evitar comportamentos de risco em mulheres com história passada ou actual de perturbações do comportamento alimentar, ou precipitar ou manter afastadas destes comportamentos as mulheres sem sintomatologia (Blais et al, 2000;Crow, Agras, Crosby, Halmi, & Mitchell, 2008;Crow, Keel, Thuras, & Mitchell, 2004;Dunker, Alvarenga, & Alves, 2009;Edelstein, 2007;Hollifield & Hobdy, 1990;Lemberg & Phillips, 1989;Mitchell-Gieleghem et al, 2002;Newton & Chizawsky, 2006;Ramchandani & Whedon, 1988), podendo estas alterações ser permanentes ou transitórias (Blais et al, 2000;Newton & Chizawsky, 2006). Siega-Riz et al (2008) constataram que as mulheres com bulimia nervosa antes e durante a gravidez exibiam padrões dietéticos diferentes das grávidas sem perturbações do comportamento alimentar.…”

“…Algumas mulheres pioram ou mesmo recomeçam estes comportamentos (Dunker et al, 2009;Edelstein, 2007;Kouba, Hälström, Lindholm, & Hirschberg, 2005;Newton & Chizawsky, 2006), sendo o principal impulsionador as alterações físicas e psicológicas que advêm da gravidez (Makino, Hashizume, & Tsuboi, 2007), nomeadamente o medo relativo ao aumento de peso (Lemberg & Phillips, 1989). Num estudo de Rand, Willis e Kuldau (1987), este medo surgiu com maior frequência no primeiro trimestre de gravidez e segundo mês do período pós-parto.…”

“…Muitas destas mulheres experienciam medo de contribuir para o mal-estar do bebé (Lemberg & Phillips, 1989;Lewis & Grange, 1994), não prevenindo muitas vezes comportamentos de risco (Lewis & Grange, 1994). O medo da perda de controlo é um medo muito comum nas mulheres com perturbações do comportamento alimentar neste perío-do (Lemberg & Phillips, 1989;Lewis & Grange, 1994;Tiller & Treasure, 1998), apesar de poder também surgir medo que a criança venha a desenvolver perturbações do comportamento alimentar, medo de não estar apta para tratar da criança ou o medo de perder a atenção do côn-juge (Lemberg & Phillips, 1989). Bakan, Birmingham e Goldner (1991) sugerem que a gravidez e as complicações natais podem constituir-se enquanto factores de risco para a cronicidade na anorexia nervosa.…”

Eating disorders in pregnancy

“…Symptoms frequently returned after delivery, and in almost half, eating was more disturbed. In another sample of 43 women reporting abnormal eating patterns during the six months before conception, symptomatic improvement occurred during pregnancy in 70%, but 44% retained some symptoms until delivery (Lemberg & Philips, 1989).…”

“…Many patients reported episodes of overeating but only one (who had a previous history of bulimia) had associated feelings of loss of control. Lemberg & Philips (1989) also reported that a fear of losing control of weight during pregnancy is commoner in patients with eating disorders.…”