As a follow up to my last post about the "Mommy Make-over", let's begin a discussion about the effects of eating disorders on pregnancy and related issues - beginning with the effects on fertility in females.
Eating disorders have been implicated in the literature as a cause of infertility (Pomeroy & Mitchell, 2002).It is estimated that as many as 1 in 5 patients at an infertility clinic is there as the result of an eating disorder and as many as 5–15% of women treated for infertility have a history of eating disorder symptoms.
Low weight as well as obesity are associated with ovulatory dysfunction and fertility complications.
Poor nutrition, endocrine changes caused by low body weight, and excessive exercise can also affect fertility.
Consultation with a gynecologist and endocrinologist can help a patient in determining if their eating disorder history may affect her ability to conceive. For individuals whose eating disorder symptoms are severe, it is recommended that such patients make gains in recovery prior to attempting to enhance fertility.
A history of eating disorders increases the risk of both medical and psychological complications during pregnancy. In addition, pregnancy may exacerbate eating disorder symptoms in some patients. Thus, ideally, a patient will wait for the "okay" from her treatment team before attempting to conceive.
Eating disorders, particularly when there is food restriction, low-weight and/or active bing/purge behaviors, can significantly increase the risk of both maternal and fetal complications, the details of which will be the subject of the next edition of Treatment Notes.
Source: Pomeroy, C., & Mitchell, J. E. (2002). Medical Complications of Anorexia Nervosa and Bulimia Nervosa. In Fairburn, C. G., & Brownell, K. D. Eating disorders and obesity: A comprehensive handbook (2nd Edition). New York: The Guilford Press.