How Real Is Pregorexia?’

Last year, various radio and TV shows such as “Fox News” and “The Early Show” reported on a new condition, “pregorexia,” a term used to describe women who cut calories and exercise excessively to avoid gaining weight during pregnancy.

How real is pregorexia? According to the American Dietetic Association (ADA), very few cases of pregorexia are actually seen. Most weight and pregnancy problems occur in the opposite direction, namely, as uncontrolled excess weight gain during pregnancy. One of the key parts of a health-promoting lifestyle during pregnancy is appropriate weight gain, which often includes consuming 2,200 to 2,900 kcal/day—depending on pre-pregnancy body mass index, rate of weight gain, maternal age, and appetite (J Am Diet Assn 2009;6:976). And, according to the ADA, obesity during pregnancy leads to increased risk of gestational hypertension, preeclampsia, and other problems.

Mothers with eating disorders

Many women with eating disorders find their symptoms lessen during pregnancy, and hormonal changes during pregnancy may counter the negative neurobiology that can contribute to eating disorders. Patients with a history of eating disorders who are at risk of relapse may need extra help during pregnancy. Some of the warning signs include wanting to talk only about calorie counts as opposed to their general health and the health of their babies, skipping meals or eating alone, and lack of a good support system (see box on page 7).

A positive result: a dialogue about weight gain

One positive result of the media hype about “pregorexia” is that it may provide an opportunity for health and nutrition professionals to have candid discussions with women about meals and nutrition during pregnancy. The ADA suggests that food and nutrition professionals encourage pregnant women to use the MyPyramid for Moms (www.mypyramid.gov), developed by the U.S. Department of Agriculture, to select a balanced diet.

Women are often pleasantly surprised to find out what makes up healthful weight gain during pregnancy, and, although that although many assume that all weight gained is fat, to learn that most of the weight comes from fluids and the baby itself. And, since iron deficiency anemia affects about 30% of low-income women who are pregnant, 27 mg of iron per day during pregnancy is recommended.

Pregorexia: Warning Signs

Several warning flags can signal possible problems with body image and weight gain in pregnancy:

• A documented history of eating disorders
• Focusing on calorie counts instead of general good health
• Eating meals alone
• Skipping meals
• A weak support system, or none