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Impact of pregnancy on bulimia nervosa

Published online by Cambridge University Press:  02 January 2018

John Farnill Morgan ,
J. Hubert Lacey  and
Philip M. Sedgwick
John Farnill Morgan*
Affiliation:
Department of General Psychiatry, St George's Hospital Medical School, London
J. Hubert Lacey
Affiliation:
Department of General Psychiatry, St George's Hospital Medical School, London
Philip M. Sedgwick
Affiliation:
Department of General Psychiatry, St George's Hospital Medical School, London
*
Dr Morgan, Department of General Psychiatry, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE; e-mail: jmorgan@sghms.ac.uk
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Abstract

Background

Bulimia nervosa affects women at a peak age of reproductive functioning, but few studies have examined the impact of pregnancy on bulimia.

Aim

To examine the impact of pregnancy on symptoms of bulimia nervosa and associated psychopathology.

Method

Women actively suffering from bulimia nervosa during pregnancy (n=94) were interviewed using the eating disorder examination (12th edn) and structured clinical interview for DSM–III–R, with additional structured questions. Behaviours were recorded at conception, each trimester and postnatally. Relative risks were calculated for prognostic factors.

Results

Bulimic symptoms improved throughout pregnancy. After delivery, 57% had worse symptoms than pre-pregnancy, but 34% were no longer bulimic. Relapse was predicted by behavioural severity and persistence, previous anorexia nervosa (‘Type II’ bulimia), gestational diabetes and ‘unplanned’ pregnancy. Unplanned pregnancies were the norm, usually resulting from mistaken beliefs about fertility. ‘Postnatal depression’ was suggested in one-third of the sample, and in two-thirds of those with ‘Type II’ bulimia, and was predicted by alcohol misuse, symptom severity and persistence.

Conclusions

Postnatal treatment intervention should focus on women ‘at risk’ of relapse, but all women with bulimia should be assessed for postnatal depression.

Type
Papers
Information
The British Journal of Psychiatry , Volume 174 , Issue 2 , February 1999 , pp. 135 - 140
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

Declaration of interest None.

References

American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.Google Scholar
Bailey, L. A. & Hailey, B. J. (1987) The psychological experience of pregnancy. International Journal of Psychiatry in Medicine, 16, 263–274.CrossRefGoogle Scholar
Butte, N. F., Hopkinson, J. M. & Nicolson, M. A. (1997) Leptin in human reproduction: serum leptin levels in pregnant and lactating women. Journal of Clinical Endocrinology and Metabolism, 82, 585–589.Google Scholar
Fahy, T. & Treasure, J. (1989) Children of mothers with bulimia nervosa. British Medical Journal, 299, 1031.CrossRefGoogle ScholarPubMed
Fairburn, C. G., Peveier, R. C., Davies, B. A., et al (1991) Eating disorders in young adults with insulin dependent diabetes: a controlled study. British Medical Journal, 303, 17–20.Google Scholar
Fairburn, C. Stein, A. & Jones, R. (1992) Eating habits and eating disorders during pregnancy. Psychosomatic Medicine, 54, 665–672.CrossRefGoogle ScholarPubMed
Fairburn, C. & Cooper, Z. (1993) The eating disorder examination (12th edn). In Binge Eating: Nature, Assessment and Treatment (eds Fairburn, C. G. & Wilson, G. T.), pp. 317–360. New York: Guilford Press.Google Scholar
Ford, M. & Dolan, B. M. (1989) Bulimia associated with repeated spontaneous abortion. International Journal of Eating Disorders, 8, 243–245.3.0.CO;2-1>CrossRefGoogle Scholar
Johnson, C., (ed.) (1991) The Psychodynamic Treatment of Anorexia Nervosa and Bulimia. New York: Guilford Press.Google Scholar
Lacey, J. H. (1984) The bulimia syndrome. In Advanced Medicine (ed. Ferguson, A.). London: Royal College of Physicians/Pitman.Google Scholar
Lacey, J. H. & Smith, G. (1987) Bulimia nervosa. The impact of pregnancy on mother and baby. British Journal of Psychiatry, 150, 777–781.Google Scholar
Lemberg, R. & Phillips, J. (1989) The impact of pregnancy on anorexia nervosa and bulimia. International Journal of Eating Disorders, 8, 285–295.3.0.CO;2-P>CrossRefGoogle Scholar
Mitchell, J. E., Seim, H. C., Glotter, D., et al (1991) A retrospective study of pregnancy in bulimia nervosa. International Journal of Eating Disorders, 10, 209–214.Google Scholar
O'Hara, M. W. (1997) The nature of postpartum depressive disorders. In Postpartum Depression and Child Development (eds Murray, L. & Cooper, P. J.), pp. 3–31. New York: Guilford Press.Google Scholar
Price, W. A., Glannini, A. J. & Loiselle, R. H. (1986) Bulimia precipitated by pregnancy. Journal of Clinical Psychiatry, 47, 275–276.Google ScholarPubMed
Raphael, F. J., Rodin, D. A., Peattie, A., et al (1995) Ovarian morphology and insulin sensitivity in women with bulimia nervosa. Clinical Endocrinology, 43, 451–455.Google Scholar
Spitzer, R. L., Williams, J. B. W., Gibbons, M., et al (1990) User's Guide for the Structured Clinical Interview for DSM–III–R Washington, DC: American Psychiatric Press.Google Scholar
Stein, A. (1995) Eating disorders and childrearing. In Eating Disorders and Obesity (eds Brownel, K. D. & Fairburn, C. J.), pp. 188–191. New York: Guilford Press.Google Scholar
Stein, A. & Fairburn, C. G. (1989) Children of mothers with bulimia nervosa. British Medical Journal, 299, 777–778.Google Scholar
Stein, A. & Fairburn, C. G. (1996) Eating habits and attitudes in the postpartum period. Psychosomatic Medicine, 58, 321–325.CrossRefGoogle ScholarPubMed
Stein, A. Murray, L., Cooper, P., et al (1996) Infant growth in the context of maternal eating disorders and maternal depression: a comparative study. Psychological Medicine, 26, 569–574.Google Scholar
Stewart, D. E., Raskin, J., Garfinkel, P. E., et al (1987) Anorexia nervosa, bulimia and pregnancy. American Journal of Obstetrics and Gynecology, 157, 1194–1198.CrossRefGoogle ScholarPubMed
Woodside, D. B. & Shekter-Wolfson, L. F. (1990) Parenting by parents with anorexia nervosa and bulimia nervosa. International Journal of Eating Disorders, 9, 303–309.3.0.CO;2-3>CrossRefGoogle Scholar
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