According to the National Institute of Mental Health, "An estimated 0.5 to 3.7 percent of females suffer from anorexia nervosa in their lifetime," and "An estimated 1.1 percent to 4.2 percent of females have bulimia nervosa in their lifetime."

(Source: American Psychiatric Association Work Group on Eating Disorders. Practice guideline for the treatment of patients with eating disorders [revision]. American Journal of Psychiatry, 2000; 157[1 Suppl]: 1-39; quoted in Melissa Spearing, Eating Disorders: Facts About Eating Disorders and the Search for Solutions, U. S. Department of Health and Human Services, Public Health Service, The National Institutes of Health, National Institute of Mental Health, NIH Publication No. 01-4901, 2001; http://www.nimh.nih.gov/publicat/eatingdisorder.cfm.) 

"Addiction, obesity, starvation (anorexia nervosa) are political problems, not psychiatric: each condenses and expresses a contest between the individual and some other person or persons in his environment over the control of the individual's body."

(Source: Thomas Szasz, "Control and Self-control," The Second Sin, 1977, in Andrews, Robert; Biggs, Mary; and Seidel, Michael, et al., The Columbia World of Quotations, New York: Columbia University Press, 1996. www.bartleby.com/66/, [21 October 2002].)

Nine researchers from the Department of Psychiatry at Harvard's Massachusetts General Hospital endeavor to determine how maternal eating disorders might affect the health and well-being of their children.

There have been a number of previous studies that, "while somewhat inconsistent, suggest that both anorexia nervosa and bulimia nervosa may negatively affect fetal outcome." These previous studies had found, among other results, higher incidences of miscarriage, lower birth weights, more premature births, and more deliveries via cesarean section. "Together these data suggest that having a past or current eating disorder may put a woman and her infant at risk for problems during pregnancy."

Interestingly, the results of this study found that "[t]he majority of the women with eating disorders had normal pregnancies, resulting in healthy babies."  However, there were significant exceptions, including, "three babies (6.1%) had birth defects, and 17 (34.7%) of the women experienced postpartum depression...and 13 (26.5%) of the women delivered by cesarean section.  Women who showed symptoms of either anorexia nervosa or bulimia nervosa during pregnancy had a higher frequency of birth by cesarean section and postpartum depression than did nonsymptomatic women."

These differences between those women who had previously diagnosed with an eating disorder, but who did not exhibit symptoms during their pregnancy, and those who were actively anorexic or bulimic included,  "The number of cesarean sections was significantly higher in the symptomatic subjects (x2=5.14, df=1, p=0.04, Fisher's exact test)."  Further, a history of substance abuse was found in half (11 of 22) of the symptomatic women, compared to only 20 percent (5 of 25) of the asymptomatic group (x2=4.75, df=1, p=0.03). Finally, "nearly one-half of the symptomatic group reported postpartum depression."

For the entire sample, both symptomatic and asymptomatic, there are some troubling findings: "The number of birth defects in the group was greater than the population-based rate of 2.5%," versus 6.1 percent for the group.  "The prevalence of clinical depression in the postpartum period in the general population is estimated to be between 3% an 12%.  Our group reported more than three times that rate (34.7%)."

The authors of the study conclude: "Pregnant women with past or present eating disorders should be viewed as being at high risk and monitored closely both during and after pregnancy to optimize maternal and fetal outcomes."