Thursday, August 13, 2009

Pregorexia: not eating for two

By Alison

Pregnant belly We all know about anorexia. Some of us may have heard of the latest eating disorder, orthorexia, or obsessive thoughts and measures taken to eat only healthy foods. There is another one: pregorexia.

I found this NY Times blog post: During Pregnancy, Starving for Two - Well Blog - It sparked my interest for two reasons: 1) I’m an RD; 2) I’m 29 weeks pregnant. Pregorexia is when women suffer from anorexia-like symptoms during pregnancy. Some speculate that images of super-svelte Hollywood divas with a barely-there baby bump are portraying the wrong image of a healthy pregnancy.

New pregnancy weight gain guidelines released by the Institute of Medicine in May 2009 recommend that a woman who falls within a normal pre-pregnancy weight range (normal BMI = 18-24.9) should gain approximately 25-35 pounds during pregnancy. Recommended weight ranges differ depending on weight status prior to becoming pregnant and if a woman is pregnant with multiples (see Pregnancy Weight Gain, New Guidelines).

Per the NY Times blog post, the momlogic blog posted an article on Maggie Baumann, a woman who gained a healthy 33 pounds during her first pregnancy, but suffered from pregorexia in her second pregnancy. Baumann’s weight gain in her first pregnancy made her feel “out of control”. Control over food and weight is a core desire for most anorexics. She went on to say in the momlogic blog post:

“My first pregnancy I felt so out of control with my body changes ... the stretching of my stomach, the increased size of my breasts ...all those changes made me feel like I was losing myself and my identity of being ‘thin’ and in CONTROL of myself. I don't remember thin celebrities impacting my decision, I just remember my goal of keeping myself small was what was deeply rooted in my core.”

According to an NBC news report, Baumann’s doctor told her she had intrauterine growth retardation, meaning her baby was at risk. This didn’t stop Baumann from eating only 1200 calories per day and sticking to a highly regimented exercise routine. At 5’8”, she only gained 18 pounds during her second pregnancy. Dr. Christine Halaburka (Silicone Valley Pediatricians) noted that restrictive eating during pregnancy can lead to abnormal brain and spinal cord development. The report goes on to mention that Baumann’s newborn developed seizures, which may have been the result of poor prenatal nutrition.

Recently, there has been a surge of news that pregnant women should take precaution when “eating for two”. I addressed this in a previous blog post, Eating for two?, where I discuss that pregnancy is not a license to go on a nine-month food binge. Yet, it seems the scale swings both ways. When it comes to pregnancy, some women are terrified of losing their figures, losing control with food, and reaching the point of no return with weight gain.

Proper nutrition is essential for a healthy baby. Gaining too much or too little weight can have an impact on mom and the baby. I speak of extremes here, not a few extra (or less) pounds here and there. Gaining 40 pounds instead of the recommended 35 pounds probably won’t put a mother and baby at risk. Gaining 80 pounds for a single pregnancy may lead to issues including gestational diabetes, plus make it more difficult for post-partum weight loss.

It is also important to incorporate moderate exercise of at least 30 minutes per day, on most if not all days (see Pregnancy Heart Rate blog articles for more information). Excessive exercise during pregnancy can lead to dehydration, weight loss, excessively high heart rates and overheating; all of which can threaten the developing baby.

Baumann’s daughters are now grown. She is a family therapist and runs two eating disorder support groups in Orange County, CA.

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