Diagnosis and Management of Eating Disorders in Pregnancy

Objective: To provide a review of the literature with regards to the diagnosis and management of eating disorders in pregnancy. Methods: Available literature was reviewed and summarized to discuss the epidemiology, diagnosis, natural history of the illness, and treatment. Results: Eating disorders are common mental health conditions in reproductive-aged women, including pregnant women. Anorexia nervosa, bulimia nervosa, and binge eating disorder are the most commonly diagnosed, with a mixed clinical picture existing due to the fluidity between these conditions. Pregnancy can often act as a trigger for eating disorders given the focus on weight gain and the stressors associated with the changing physical appearance of pregnancy. There are significant maternal and fetal risks associated with eating disorders in pregnancy including an elevated risk of cesarean delivery, postpartum depression, preterm delivery, and perinatal mortality. Treatment of eating disorders should involve a multidisciplinary team of providers with close monitoring in pregnancy and the postpartum period with honest discussions on handling weight gain and triggering restrictions associated with pregnancy. Conclusion: Pregnancy is a high-risk time for women with eating disorders given the significant maternal and fetal risks of their illness.