I spent a lot of time trying to figure out how I could lose weight fast after the baby was born. Darren came with me to childbirth classes and tried to comfort me when I complained about being fat. He would reassure me that he loved me as I was and would love me at any size. The birth of my healthy baby, Suzanne, was a joy unlike any I’d experienced before.”

It was important that Sybil had made significant progress in treatment prior to getting pregnant. Women with eating disorders who recover prior to conception and maintain adequate nutrition throughout pregnancy are not at substantially higher risk of obstetrical problems than those who have never had an eating disorder. Actively engaging in abnormal weight control practices during pregnancy can increase vulnerability to complications, such as miscarriage, premature delivery, Cesarean delivery, and low-birth-weight babies. To prevent such problems, obstetricians monitor each patient based on her individual needs.

Yet women who have had anorexia or bulimia do not necessarily share this information with their obstetricians. Many are embarrassed about their past eating behavior and go to great lengths to keep it secret. Pregnancy can aggravate this sense of shame. Perhaps your daughter is afraid that if she tells her obstetrician about her past or present abnormal eating behaviors, he will pass judgment on her or lose respect for her. Let her know that even if she feels that she is beyond the point where her disorder will return, it is best for her to reveal her history to her doctor(s).

On occasion, the illness gets worse during pregnancy; for many women, however, pregnancy is a time when abnormal eating behaviors improve. If your daughter has been on medication prior to becoming pregnant, she needs to talk with her prescribing physician about continuing to take it. Being able to discuss her past and present problems with a therapist can provide her with an important safety net and help ensure that she receives the professional monitoring she needs while she is pregnant.

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David B. Herzog, M.D., Debra L. Franko, Ph.D., Pat Cable, RN

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David B. Herzog, M.D., is the Harvard Medical School Endowed Professor of psychiatry in the field of eating disorders at Massachusetts General Hospital and the director of the Harris Center at Massachusetts General Hospital.
Debra L. Franko, Ph.D., is a professor in the Department of Counseling and Applied Educational Psychology at Northeastern University and the associate director of the Harris Center at Massachusetts General Hospital
Pat Cable, RN, is the director of publications at the Harris Center.