Malnourished Mommies

The desire to remain thin while pregnant causes some women to take drastic measures, usually to the detriment of their unborn child. When women get pregnant, their most frequent thoughts about food usually have to do with what flavor ice cream to pair with their pickles. However, it seems that a new trend is taking over the pregnant community at a rapid rate. Women are becoming worried about maintaining a small size while pregnant, and it is causing them to employ unsafe practices in order to maintain an unrealistic and unhealthy weight. The new term coined for this epidemic is pregorexia.

It can include different behaviors including not consuming sufficient amounts of calories, starving oneself, purging, or use of laxatives or diuretics. Pregorexia also includes exercising over-zealously in an attempt to ward off those pesky pregnancy pounds.

The travesty of pregorexia is not just that these women are harming their own bodies, they are harming their already fragile fetuses. “I have had women very concerned with their weight gain in pregnancy and we just continue to encourage and remind them they are not really eating for themselves, but they are eating for their baby,” says Dr. Jennifer Pugliese, an obstetrician and gynecologist in Lafayette. “The baby gets all its nutrition from what the mother takes in, so if the mother has insufficient nutrition then by default it is being depleted from the baby, which can cause pregnancy complications as well as complications when the baby is born.”

Complications for the infant include low birth weight, poor fetal weight, pre-term labor and delivery, feeding problems, respiratory distress or even death. “Perinatal mortality, which means death of the baby either just before or after birth, is six-fold increased in women with eating disorders while pregnant,” says Pugliese. It can also cause problems later in the child’s life such as seizures, neurological disorders, and ADHD.

While pregorexia is obviously more prevalent in those who are already struggling with an eating disorder, even women who have never before had weight issues may find themselves falling into the trap of an eating disorder while expecting.  “A lot of women struggle with their self image during pregnancy,” says Pugliese, “so it is not surprising that pregorexia can develop in someone who has never had an eating disorder before.”

If a woman is that worried about her weight, it is perfectly okay to exercise and watch calories as long as it is done the right way and the baby’s needs and health are being taken into account. Dawn Foreman, a registered dietician, licensed nutritionist, certified personal trainer, and owner of Personally Fit, Lafayette’s Premier Health Club for Women, says that exercising while pregnant is perfectly fine, but the workouts need to be more about keeping healthy and not about changing drastically. “The main focus for exercise during pregnancy should not be on dramatic improvements in strength or endurance,” says Foreman, “this is the time to maintain activity to prevent some of the muscle and joint stress that naturally occurs during pregnancy.”

A good workout routine that she suggests is 30 minutes of aerobic activity on most days of the week, core exercises three times per week (however it is not recommended to do exercises lying on your back after the first trimester), back stretches and Kegel exercises everyday, and moderate strength training two days a week. “Never start an exercise program without approval from your physician,” Foreman warns.

Proper nutrition is also extremely important. A woman needs to take in more calories to ensure her baby is getting enough nutrients. But it is not quite as much as some women fear or expect. “Your calorie needs increase about 100 to 300 calories per day when you are pregnant,” says Foreman. “This isn’t a whole lot of food; it’s equivalent to a small snack.  Three-hundred calories equals about one apple with two tablespoons of peanut butter or six ounces of yogurt with a quarter cup of fresh blueberries and one ounce of almonds.”

The American Congress of Obstetrics and Gynecology recommends  if you are underweight to gain 28 to 40 pounds, normal weight should gain 25 to 30 pounds and if you are carrying twins 35 to 45 pounds. If you are overweight you should gain 15 to 25 pounds and obese women should gain at least 15. “Your physician will let you know how much weight gain is appropriate for your situation; listen to him carefully,” says Foreman.

“This is not the time to focus on losing weight or even maintaining your pre-pregnancy weight,” says Foreman. “The most important thing to remember at this time is to provide your body with the nutrients and movement needed to support growth of your baby while not compromising your health and well-being during pregnancy and after delivery.”