How difficulties with pregnancy and childbirth are related to binge eating and bulimia

Many young women with an eating disorder will at some point wonder how their struggles with eating may relate to their ability to have a child in the future. A new study examined how rates of miscarriage, abortion, and successful childbirth differed among women who suffered from an eating disorder compared to the general population.

The study was released online two days ago in the International Journal of Eating Disorders. Researchers in Finland identified over 2,000 women who sought treatment for an eating disorder and followed up with them over several years to ask about pregnancy and childbirth. The average age of the women at the start of the study was 25 and the maximum age until which women were followed was 50. The researchers were able to compare these women to a control group from the general population by accessing several large population databases in Finland including the Central Population Register and the Register on Induced Abortion.

Women with all eating disorders (including anorexia, bulimia, and binge eating) were more likely to be single/divorced and childless during the study period compared to the control group. Among the general population 49% of women did not have children, while 61.8% of women with eating disorders did not have children.

Women with binge eating disorder had the highest rates of miscarriages compared to women with other eating disorders and the control group. For women with bulimia, however, rates of miscarriage were similar to the control group. The researchers speculate this may be due, in part, to the fact that many of the women seeking treatment for binge eating were obese and health problems associted with obesity are related to miscarriage.

Women with bulimia were most likely to have had an abortion compared to women with other eating disorders and the control group. While this is simply a speculation, the researchers suggested that because impulsivity is a common characteristic among women with bulimia, they may have engaged in riskier sexual behavior leading to more unplanned pregnancies. Given the cultural influences on abortion, it would be interesting to see if the same patterns would have emerged in different countries.

The study results are, of course, correlational meaning that there is no evidence that binge eating or bulimia actually caused miscarriages, fewer pregnancies, or abortions. It’s also important to keep in mind that the women studied here were ones who actually sought treatment and the results might have been different if a broader group of women with eating issues were included. 

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Dr. Gupta is a professor at Barnard College of Columbia University and provides individual therapy at Tribeca Psychology

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