In a story by Kathryn Balch on Good Morning America in 2009 she spoke about a young woman by the name of Melissa Henriquezth and her experience with pregnancy and her eating disorder. Melissa was pregnant with her first child. Melissa also hates fat. She told Kathryn of the moment she went to put on her favorite jeans and could not button them up. If it were any other time, Melissa would go for a long run to burn extra calories; she would only eat grilled chicken and vegetables for lunch. But, she folded the jeans and put them away, without remorse.
Melissa, who was 30, had never been pregnant before, though she’d always welcomed the thought of becoming a mom one day. Now motherhood beckoned. Yet part of her squirmed when she thought about the weight gain. Her thoughts ran constantly. Am I eating for two people? How many calories does the baby need? How many meals are enough?
At the first doctor’s visit , she was told not to dramatically change her diet; she would only need to eat between 200 and 500 calories more per day. Melissa vowed to accept the weight gain and emotional stress with it in order to have a healthy daughter.
But she neglected to tell her doctor about her eating disorder — a situation all too common for women with the condition.
Pregnant women in general have a more exaggerated sensitivity to changes in their body shape, but for those suffering from an eating disorder, the heightened sensitivity can trigger life-threatening behaviors like starvation or purging. An eating disorder puts a pregnancy at high-risk if the mother does not nourish herself properly.
Some experts estimate that as many as one in 20 women suffer from an eating disorder while pregnant. But shame, secrecy and denial are inherent in eating-disorder patients, so the numbers do not account for those who are unwilling to describe symptoms to their obstetricians.
Visible symptoms can arise when the mother does not gain an adequate amount of weight (generally 25 to 35 pounds) or experiences hyperemesis, a severe form of morning sickness causing excessive vomiting and nausea. Pregnant mothers who purge can easily hide their behavior by blaming it on normal morning sickness or nausea.
Pregnant women with eating disorders are also prone to obstetric complications. Many have increased rates of difficult labor, like breech delivery, using forceps and Caesarian sections. Most commonly, when the mother acts on an eating disorder during pregnancy, a fetus will experience a low birth-weight, growth retardation and vitamin deficiencies, which can lead to more severe conditions.
Some pregnant women have two competing forces demanding medical attention: the baby and the eating disorder. Who or what demands priority of treatment can differ depending on whom you ask — the obstetrician or the therapist.