Examining the Relationship Between Eating Disorders and Gestational Weight Gain: A Systematic Review

Abstract

Objective

Pregnant women face significant changes in their body image, weight, and overall appearance, potentially leading to the development of an eating disorder or exacerbation of a pre-existing eating disorder during pregnancy. Despite the known risks of insufficient or excess gestational weight gain (GWG), few studies have examined the relationship between eating disorders and GWG. The objective of this study was to examine the relationship between GWG and eating disorders in women with anorexia nervosa, bulimia nervosa, and binge eating disorder.

Data Sources

CINAHL, Embase, PsycInfo, and PubMed.

Study Selection

A search strategy was developed and entered into CINAHL, Embase, PsycInfo, and PubMed for studies published since 1994 that included participants with a singleton pregnancy; a clinical diagnosis of anorexia nervosa, bulimia nervosa, or binge eating disorder; and ≥18 years of age.

Data Extraction and Synthesis

Titles and abstracts were reviewed, followed by full-text review and a quality assessment. An integrated approach was undertaken, including line-by-line coding of eligible papers, development of preliminary descriptive themes based on these codes, and amalgamation of the themes to describe the relationship between eating disorders and GWG. A total of 1471 articles were identified, 14 of which met the inclusion criteria for the study. Three themes emerged: body image concerns, fear of GWG and postpartum weight retention, and prioritizing the health of the baby.

Conclusion

The identified themes inform the relationship between anorexia nervosa, bulimia nervosa, and binge eating disorder and guideline-discordant GWG. These findings are relevant for persons who provide prenatal care to patients with previous or current eating disorders.