Expert: Meg - 4/20/2004

Question
I am doing a case study (I am a nursing student).  I am having a hard time finding the information I need.  My patient is a 25-year-old pregnant woman with borderline anorexia.  I need to find out how she can deal with her obsession with her weight and body image, why she must gain the weight recommended, what long-term effects this could have on the baby, why she might have a problem following her doctor's advice, how she can reduce her problems and meet her nutritional needs, etc.

I will understand if you can't help me with this.  I am just having a horrible time with this case study.  They sort of threw it on us with no guidance and I don't have enough education to know these things yet.

Thanks for whatever help you are able to provide.


Answer
Hi Crystal-

I don't know that much about the pregnancy aspect and all the details as to how malnutrition effects a fetus...but can point you towards some helpful sites that might hold more information.  A really great resource is www.something-fishy.org in terms of the thinking behind anorexia as well as physcial complications.  Its really a more comprehensive website so I've also found the following links that appear to focus more on pregnancy and anorexia.

http://www.cfpc.ca/cfp/2003/Apr/vol49-apr-clinical-1.asp
http://www.anred.com/pg.html
http://msms.essortment.com/anorexiapregnan_rsjp.htm

That said, in terms of dealing with the weight gain of pregnancy and the body image woes that are likely, I would definitely recommend that this person (or hypothetical person as the case may be) work with both a nutritionist as well as a therapist during the process to make sure that she stays on track.  I've heard stories of how women are sometimes able to take better care of themselves during pregnancy and put the baby's health first, but then slip after giving birth.  I'm also sure that for some women, the eating disorder mindset is so deeply emmeshed that she may *know* in theory what she should do (ie: eating balanced meals, not purging, not over exercising, not taking diet pills) and still might not be able to do that.  I'm sure this would be so very frusterating and give fuel to the self hatred that is often present in eating disorders-so for this scenerio, it would be even more imporatant that she have support and even someone monitering her throughout the pregnancy.

I'm sorry that I'm not more help with this, and hope that at least the listed sites might give you some furhter information.  Please do not hesitate to write again if there is anything more I can answer and best of luck with your case study and your nursing program.

Take care,
Meg