Pregnancy: outcome and impact on symptomatology in a cohort of eating-disordered women.

OBJECTIVE: This study investigates both the impact of eating disorders (ED) on pregnancy outcome and the impact of pregnancy on cognitive and behavioral symptoms of EDs. METHOD: Data on pregnancy outcome (live birth [LB], therapeutic abortion [TAB], and spontaneous abortion [SAB]) and ED symptomatology were collected as part of a large, prospective longitudinal study of anorexia nervosa (AN) and bulimia nervosa (BN). Data were gathered using a semistructured interview administered every 6 months to 246 subjects. RESULTS: We identified 54 women who reported 82 pregnancies (46 LB, 25 TAB, and 11 SAB). Pregnancy outcome was not significantly related to any of the clinical variables studied. Women with BN showed a significant decrease in the severity of their ED symptoms during pregnancy, and this decrease was sustained through 9 months postpartum. Women with AN also demonstrated a significant reduction in ED symptoms, however, these symptoms returned to prepregnancy levels by 6 months postpartum. CONCLUSIONS: Our prospective findings reveal an elevated TAB rate for ED women along with a general reduction in the severity of ED symptoms during pregnancy.

Comorbidity and outcome in eating disorders.

This article reviews the data on comorbidity, course, and outcome in anorexia nervosa and bulimia nervosa. Recovery, relapse, the process of recovery, and predictors of outcome are reviewed. Although significant differences exist among outcome studies, the data suggest that patients with anorexia and bulimia tend to improve symptomatically over time. Anorexia nervosa and bulimia nervosa are associated with substantial rates of comorbidity. The relationship between eating disorders and depression, anxiety disorders, substance abuse, and personality disorders is discussed.