Pregnancy and Eating Disorders

Dr. David Herzog was the first Endowed Professor of Psychiatry in the Field of Eating Disorders at Harvard Medical School. He is board certified in pediatrics, child and adolescent psychiatry and general psychiatry and has treated over 3,000 individuals with anorexia nervosa, bulimia nervosa, and associated diagnoses. Dr. Herzog founded and directed the Harvard Eating Disorders Center, which later became the Harris Center for Education and Advocacy in Eating Disorders at Massachusetts General Hospital. 

In 1987, Dr Herzog initiated his National Institute of Mental Health-funded Longitudinal Study of Anorexia and Bulimia Nervosa, mapping the course and outcome in 246 women followed at frequent intervals. The Longitudinal Study – the largest and most extensive of its kind – has provided a better understanding of how anorexia and bulimia progress, including rates of recovery and relapse, medical consequences, associated psychiatric illnesses, the quality of patients’ relationships, and functioning at school or at work.

As part of the Longitudinal Study, Dr. Herzog and his team examined the course of pregnancy and neonatal status for babies born to women with eating disorders. Forty-nine live births were included.  The participants were interviewed by trained assistants and completed a brief self-report questionnaire that assessed both birth statistics and birth-related complications. Medical records and/or self-report data describing the babies’ birth status were obtained.

The researchers found that women with eating disorders who regain their health prior to conception and remain nutritionally stable throughout pregnancy are not more prone to obstetrical problems than those who have never had an eating disorder. However, engaging in abnormal weight control behaviors during pregnancy can increase the risk of complications such as miscarriage, premature delivery, Cesarean delivery, low-birth-weight babies, and postpartum depression.

The results of this study emphasized the importance of viewing pregnant women with past or current eating disorders as high risk and monitoring them closely both during and after pregnancy to optimize maternal and fetal outcomes.