Reprinted from Eating Disorders Review
November/December 2003 Volume 14, Number 6
©2003 Gürze Books
Bulimia nervosa (BN) can have long-ranging adverse effects upon reproductive function. To clarify this, Dr. Frances A. Carter and colleagues followed a group of 150 women, including 125 women who became pregnant and had babies following treatment for BN (Int J Eat Disord 2003; 34:337).
Dr. Carter and associates hypothesized that women who were functioning well after treatment for BN would be more likely to have a baby over the 5-year period follow-up period than women who continued to be symptomatic after treatment. As predicted, women who had a baby during the 5-year follow-up period had reported significantly fewer symptoms after treatment.
There were significant differences were reported for the entire primary and several of the secondary and tertiary severity measures of BN after treatment. Women who had a baby during the follow-up period were more likely to have had BN for a longer time, and to be older (26 to 35 years old) than the women who did not become pregnant. They were also more likely to be married or in a loving relationship and living with that person. Finally, they were less likely to report loss of sexual interest or pleasure after treatment for BN.
Women who did not become pregnant during the follow-up study had several characteristics in common. They were more likely not to have had a baby if they were younger or older than 26 to 35 years of age and not living with a spouse or partner. Other factors that worked against becoming pregnant included continued binge eating and purging, body dissatisfaction, and loss of sexual interest or pleasure after treatment.
Body mass index (BMI) did not seem to affect successful pregnancy, even though previous case studies have shown that BMI is relevant to reproductive functioning among women with disordered eating (J Psychosomatic Res 1998; 44:491).
Did pregnancy have any negative effects?
In a previous report of the same group of women, the authors examined whether having a baby during the follow-up period was detrimental in any way to the women. During the year before and the year after childbirth, having a child was not associated specifically with an increase in bulimic symptoms or major depression.
Thus, the two studies suggest that women who are functioning poorly after being treated for BN are less likely to have a child during follow-up, but that having a baby after treatment does not negatively impact recovery. The authors suggest that women with BN should be encouraged and supported to take full advantage of treatment before attempting to become pregnant.
