Eating disorders are more common than is realised in women of reproductive age. Anorexia nervosa has a prevalence of up to seven per 1000 in the UK population and is especially common in adolescent girls and young women.1 Bulimia nervosa is more common and affects a slightly older age group, with a prevalence of 0.5-1% in women of reproductive age.1 Atypical eating disorders (eating disorder not otherwise specified) are probably even more common, but little is known about their prevalence. People in the atypical group have abnormal eating behaviour but do not meet the diagnostic criteria for anorexia nervosa or bulimia nervosa.1 A retrospective questionnaire study of 454 women, three to seven months postpartum, reported an 11.5% prevalence of some type of eating disorder, with a predominance of younger women affected.2

Pregnancy can complicate an eating disorder as changes in body shape may increase anxiety about weight gain. Women with a history of eating disorder should be monitored frequently during pregnancy and postpartum; they also need enhanced support with breast feeding (see Scenario box).