Q: I've suffered from anorexia in the past, but currently my weight is stable and my diet is more than adequate. I want to get pregnant, but will my previous eating disorders affect my pregnancy?
A: One of the signs that your nutrition has improved and that your body is back to a normal status is the fact that you are having (and I hope you are) regular periods again. As you know (and to review for my other readers), anorexia nervosa is a psychiatric illness that is mostly seen in adolescent girls and young women. It's associated with an intense fear of gaining weight and a change in the perception of your body weight and shape, so that your nutrition becomes severely diminished, as does your weight.
This could result in major medical problems which can be fatal. When a young woman is anorexic she may develop an irregular heartbeat, heart failure, significant changes in ovarian, adrenal and thyroid hormone production, and major changes in her gastrointestinal function. Vomiting and laxative abuse, which often accompany eating disorders, can cause permanent kidney damage. Lack of estrogen production, which is what causes the lack of periods in young women who suffer from anorexia, leads to osteoporosis: at a critical young age this can prevent the normal development of the skeleton and pelvis. If this stunting is severe, it could, in theory, affect a woman's ability to vaginally deliver her baby. The good news, though, is that a recent study from Scandinavia that compared over 1,000 women who had been diagnosed with anorexia nervosa to over 800,000 women without an eating disorder didn't show this to be the case. The study found there seemed to be no major problems with pregnancy and delivery in the women who previously had an eating disorder. The only newborn—related issue was that their babies were slightly lower in mean birth weight, but were still in the normal range for their gestational age.
Another interesting fact brought up by this study: The women with past eating disorders tended to be of normal weight (rather than overweight), and had less cesarean sections and vacuum extraction births than that of the general population. This, of course, shouldn't encourage a women to be anorexic prior to conceiving, but it is encouraging to know that a woman with this condition who gets back to a normal weight, normal nutritional status, and has normal periods can expect to have a normal pregnancy.
There is one caveat (and aren’t there always caveats in medical studies and subsequent declaration of positive or negative conclusions...), women who were diagnosed with anorexia were at a slightly increased risk of developing postpartum depression. Anorexia is, in many cases, accompanied by or even attributed to underlying depression. The drop in hormones that accompanies delivery (which can lead to a “let down” in mood in all women) may be exaggerated and more likely to develop into true postpartum depression in women who have a history of clinical depression. Let your doctor know that you have suffered from anorexia in the past so that she or he can provide appropriate support and surveillance once you have the baby.
Dr. Reichman’s Bottom Line: Women who used to have an eating disorder but are no longer anorexic don't need intensive prenatal care and can have a normal pregnancy and delivery.
Dr. Judith Reichman, the TODAY show's medical contributor on women's health, has practiced obstetrics and gynecology for more than 20 years. You will find many answers to your questions in her latest book, "Slow Your Clock Down: The Complete Guide to a Healthy, Younger You," which is now available in paperback. It is published by William Morrow, a division of .
PLEASE NOTE: The information in this column should not be construed as providing specific medical advice, but rather to offer readers information to better understand their lives and health. It is not intended to provide an alternative to professional treatment or to replace the services of a physician.