Bulimia nervosa during pregnancy: a review

Pregnant women with bulimia nervosa present interesting practice challenges for dietitians and healthcare professionals due to potential complications of bulimia nervosa for both mothers and fetuses. This review summarizes case study reports, case series reports, and retrospective studies of women with bulimia nervosa during pregnancy, and focuses on relationships among bulimic behaviors, pregnancy results, and birth outcomes. Pregnancy and birth outcomes of women with bulimia nervosa varied among individuals and studies. Material outcomes of concern included miscarriages, inappropriate weight gains (excessive or inadequate), complicated deliveries, and resumed and/or continued bulimic behaviors shortly after parturition. Fetal complications included low birth weights, prematurity, malformations, and low Apgar scores. Screening to detect bulimic behaviors is recommended, as is multidisciplinary treatment of pregnant women with bulimia nervosa to emphasize adequate dietary intakes, promote appropriate weight gains, and help achieve healthy infant outcomes in addition to long-term, healthy eating habits for these women. Future research regarding maternal and fetal outcomes of women with bulimia nervosa during pregnancy, conducted by registered dietitians, is needed to provide greater clarity and understanding of the impact of bulimic behaviors, dietary intakes, and nutritional status during pregnancy on maternal and fetal health.