Eating disorders and obstetric-gynecologic care.
OBJECTIVE
Disordered eating can have consequences for gynecologic and obstetric patients and fetuses. Amenorrhea, infertility, hyperemesis gravidarum, and preterm birth have been linked to eating disorders (EDs). This study aimed to evaluate obstetrician-gynecologists' ED-related knowledge, attitudes, and practices.


METHODS
Questionnaires were sent to 968 Fellows of the American College of Obstetricians and Gynecologists between November 2007 and March 2008. Data were analyzed separately for generalists (provide obstetric and gynecologic care) and gynecologists only (treat only gynecologic patients).


RESULTS
A majority of obstetrician-gynecologists assess body weight, exercise, body mass index, and dieting habits. Less than half assess ED history, body image concerns, weight-related cosmetic surgery, binging, and purging. Over half (54%) of generalists believed ED assessment falls within their purview. Most (90.8%) generalists agreed or strongly agreed that EDs can negatively impact pregnancy outcome. A majority rated residency training in diagnosing (88.5%) and treating (96.2%) EDs as barely adequate or less. Most knew low birth weight (91%) and postpartum depression (90%) are associated with maternal EDs, though over a third was unsure about several consequences. Some gender differences emerged; females screen for more ED indicators and are more likely to view ED assessment as within their role.


CONCLUSIONS
Despite the consequences of EDs and the fact that most physicians agree EDs can negatively impact pregnancy, only about half view ED assessment as their responsibility. Only some weight- and diet-related topics are assessed, and there are gaps in knowledge of ED consequences. Obstetrician-gynecologists are not confident in their training regarding EDs. Improvement in knowledge and altering obstetrician-gynecologists' view of their responsibilities may improve ED screening rates.
Leddy
Meaghan A
MA
Research Department, American College of Obstetricians and Gynecologists, Washington, DC20024, USA. mleddy@acog.org
Jones
Candace
C
Morgan
Maria A
MA
Schulkin
Jay
J
D000328:Adult; D001291:Attitude of Health Personnel; D001068:Feeding and Eating Disorders / Q000175:diagnosis / Q000517:prevention & control*; D005260:Female; D006176:Gynecology / Q000458:organization & administration; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009774:Obstetrics / Q000458:organization & administration; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000517:prevention & control*; D011295:Prenatal Care / Q000379:methods*; D011361:Professional Competence; D014481:United States; D016387:Women's Health