Eating disorders and pregnancy do not go well together. Ignoring an eating disorder can be dangerous for you, your pregnancy, and your baby. If you have an eating disorder, you have extreme and unhealthy emotions, attitudes, and behaviors that center around food, gaining weight, and your body image. Pregnancy is a time when you have to gain weight and your body will change. This can be a frightening prospect. [1-3]
There are about 7 million women in America right now with an eating disorder and most of them are in their childbearing years. That means many women with eating disorders are becoming pregnant. If you are one of them, the good news is that many can get pregnant and have normal pregnancies and healthy babies. However, there are real dangers that you should not ignore. 
How Can an Eating Disorder Affect Pregnancy?
Any eating disorder can be a problem, but different types of eating disorders tend to have different problems: [1-2]
- If you have anorexia, extreme dieting or exercising usually results in loss of your regular menstrual cycle. That makes it very hard to get pregnant. If you do get pregnant, you are at higher risk for stillbirth, premature birth, or having a low birthweight baby.
- If you have bulimia, binge eating followed by purging can cause menstrual irregularities. About half of women with bulimia stop having periods. If you do get pregnant, you are at risk for miscarriage, premature birth, or a low birthweight baby.
- If you have binge eating, you may gain too much weight. This can put you at risk for gestational diabetes, high blood pressure, a larger than normal baby, and need for a C-section birth.
After pregnancy, having an eating disorder can make it harder to breastfeed and more likely that you will suffer from postpartum depression. OK, that sounds like a lot to overcome, but it is not hopeless. With the right help, you can manage both your eating disorder and your pregnancy. [1-3]
Managing Pregnancy and Eating Disorders
The ideal time to start is before you get pregnant. Have a preconception visit to discuss your eating disorder. Be honest with your doctor. Tell your doctor about any history of eating disorder symptoms, even if it was years ago. Pregnancy can trigger a relapse. [1-3]
It is best to start working with an eating disorder counselor and nutrition specialist. You want to have a few months of weight gain and healthy nutrition under your belt before trying to get pregnant. 
If you become pregnant before you have a chance to talk to your doctor. Do not wait. Be honest up front about your eating disorder. The key to a successful pregnancy is going to be maintaining nutrition and a healthy weight to keep you and your baby healthy through pregnancy. You want to get a counselor, nutritionist, and a lactation consultant on your pregnancy care team. [1-3]
Maybe pregnancy is an opportunity to get your eating disorder under control. The fact that you are eating for two and responsible for a new life may be more important than your previous emotions, beliefs, and behaviors. You will need some help, but help is available. You just have to ask.