Is pregnancy a trigger for recovery from an eating disorder?

Objective: Pregnancy produces significant changes in a woman's body weight and shape. This study examines changes in body mass index (BMI) and quality of life related to eating disorders (QOLED) prior to, during and after pregnancy in both women with and without eating disorders.

Design: Prospective study.

Setting: Royal North Shore Hospital, Northshore Private and Northside Clinic, Sydney.

Sample: The study comprised 178 pregnant women.

Methods: Women completed the QOLED questionnaire retrospectively before pregnancy, prospectively for each trimester of pregnancy and at 3, 6 and 12 months postpartum. The QOLED is a validated questionnaire used to assess quality of life related to eating disorders, including physical health, social function and psychological state. Changes in current BMI and QOLED were examined across the stages of pregnancy.

Results: The women with eating disorders (n = 19) had significantly lower BMIs before, during and after pregnancy. Both women with and without eating disorders had significant weight gain in the second and third trimesters compared with pre-pregnancy. There were significant interactions between stage of pregnancy and eating disorder status on global QOLED scores. These scores improved significantly during second and third trimesters compared with pre-pregnancy but varied after pregnancy, particularly among women with eating disorders. The QOLED scores for women with eating disorders remained within the eating disorder range throughout the study.

Conclusions: Pregnancy is not associated with recovery from eating disorders. Women with eating disorders need support during pregnancy and the postnatal year, and should not be told that their eating disorder will improve during this time.