Anorexia Nervosa

Obstetric Complications of Anorexia Nervosa

Medical Journal of Obstetrics and Gynecology
By Kamila Cass, PhD, CEDS Philip S. Mehler, MD, FACP, FAED, CEDS


The eating disorder, Anorexia Nervosa (AN), leads to a malnourished state and negatively impacts every system of the body. There are unique obstetric and gynecological concerns affecting females with this illness, and despite recent findings, several misconceptions persist. Among these is the fallacy that females with AN cannot get pregnant. Though many patients with AN experience amenorrhea, a considerable minority continue to retain their menses, and should be educated about the possibility of unplanned pregnancy. When pregnancy does occur, it is considered high risk, with increased likelihood of miscarriage, premature birth, and low birth weight infants. Patients with AN should be seen by a high-risk obstetric specialist and have a multidisciplinary team consisting of eating disorder experts including a registered dietician and a psychotherapist. Given their underweight status, a weight gain of 30- 40 lbs is recommended. Contrary to previous thought, women who recover from AN do not have a greater risk for infertility, though resumption of menses can take up to 12 months. Though oral estrogen is beneficial to treat osteoporosis of post-menopausal women, oral estrogen is not beneficial for bone health in AN.

Written by

Kamila Cass, PhD, CEDS

Dr. Kamila Cass is a Clinical Psychologist at the ACUTE Center for Eating Disorders at Denver Health, providing psychodiagnostic assessment, individual and group psychotherapy, and crisis intervention…
Written by

Philip S. Mehler, MD, FACP, FAED, CEDS

Dr. Philip S. Mehler began his career at Denver Health more than 35 years ago and was formerly its Chief of Internal Medicine and then Denver Health’s Chief Medical Officer (CMO) until he was promoted…

ACUTE Earns Prestigious Center of Excellence Designation from Anthem
In 2018, the ACUTE Center for Eating Disorders & Severe Malnutrition at Denver Health was honored by Anthem Health as a Center of Excellence for Medical Treatment of Severe and Extreme Eating Disorders. ACUTE is the first medical unit ever to achieve this designation in the field of eating disorders. It comes after a rigorous review process.

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