Research indicates that eating disorders are one of the least likely psychological disorders to receive adequate treatment, resulting in serious consequences. The psychological treatment of individuals with eating disorders is a challenging endeavor, with many individuals lacking the motivation to change, thus requiring long term and costly therapy. Individuals with binge eating disorder (BED) engage in the rapid consumption of a subjectively large amount of food and experience feelings of powerlessness when eating. Many binge eaters report doing so to eliminate feelings associated with anxiety, depression and loss of control and may also report low self esteem and lack of self-awareness.

 The hormonal changes associated with pregnancy often produce unstable emotions characterized by mood swings and feelings of despair. Unwanted pregnancies cause an increase in anxiety, depression and feelings of powerlessness. For individuals who have not developed effective coping strategies to deal with these emotional shifts, previously or newly learned binging behaviors may emerge.

Case:

38 year old female, 24 weeks gestation who presents to office with 35 pound weight gain and feelings of low self-esteem and guilt, complaining that she is "ugly and fat." Questionable history of obsessive-compulsive disorder and anxiety disorder. Screening tools and therapuetic communication techniques are used to evaluate for anxiety, depression and eating disorders. revealing binge-eating disorder. 

This presentation will discuss screening tools to detect binge eating and identify risk factors associated with BED. Information about referral, consultation and interventional strategies (including therapuetic communication) will be discussed. Participants will also be provided details that will be useful in implementing a simple and cost affordable BED prevention program based on recent evidence based literature.

Conclusion:

Recently, a large long-term study that examined eating disorders in pregnant women revealed that pregnancy may trigger the exacerbation or first occurrence of BED.  Though the adverse outcomes of BED are still not fully known, individuals with BED may experience excessive weight gain and obesity. Obese pregnant women have a greater risk for pre-eclampsia, gestational diabetes, cesarean delivery and post partum infection. Women’s health practitioners and midwives may lack the necessary screening, assessment and interventions needed when caring for pregnant women with BED.

Keywords: binge-eating, eating disorder, pregnancy, anxiety, obsessive compulsive disorder