Psychological Medicine, 1991, 21, 577-580 Printed in Great Britain

EDITORIAL

Eating disorders in pregnancy1
During pregnancy, most women will experience a short-lived and benign disturbance in their normal eating patterns. The majority report the onset of cravings or aversions to certain food-stuffs while a small number indulge in pica, the consumption of non-nutritious substances such as soap or clay (Dickens & Trethowan, 1971). These disturbances usually remit after delivery and rarely give rise to physical complications for mother or foetus. However, more serious and chronic eating disorders including bulimia nervosa and anorexia nervosa may also occur during pregnancy. These conditions are most prevalent among women of childbearing age and some evidence suggests that both disorders can also be precipitated by pregnancy (Weinfeld et al. 1977; Price et al. 1986). The prevalence of eating disorders among pregnant women is unknown, but the low body weight and sexual inactivity of anorexic women suggests that this disorder is much less common than in the general population. Markedly reduced fertility rates have been confirmed in long-term outcome studies of these patients (Brinch et al. 1988). Comparable data are not available for bulimia, but most of these patients are of normal weight and they are more likely to be married than anorexics. Although the prevalence rate for bulimia in women is approximately 1 % (King, 1986; JohnsonSabine et al. 1988), and partial syndromes are also common, no cases were reported in a random series of 119 primigravidae (Kumar & Robson, 1984) or in 92 obstetric patients referred for assessment by a liaison psychiatrist (Appleby et al. 1989). Such low rates of diagnosis may be due to the reluctance of patients to disclose details of their behaviour in the absence of specific questions about dietary habits and attitudes to weight