title: Obstetric and gynecologic problems associated with eating disorders.
abstract: OBJECTIVE
  This article summarizes the literature on obstetric and gynecologic complications associated with eating disorders.
  
  
  METHODS
  We performed a comprehensive search of the current literature on obstetric and gynecologic complications associated with eating disorders using PubMed. More recent randomized-controlled trials and larger data sets received priority. We also chose those that we felt would be the most relevant to providers.
  
  
  RESULTS
  Common obstetric and gynecologic complications for women with eating disorders include infertility, unplanned pregnancy, miscarriage, poor nutrition during pregnancy, having a baby with small head circumference, postpartum depression and anxiety, sexual dysfunction and complications in the treatment for gynecologic cancers. There are also unique associations by eating disorder diagnosis, such as earlier cessation of breastfeeding in anorexia nervosa; increased polycystic ovarian syndrome in bulimia nervosa; and complications of obesity as a result of binge eating disorder.
  
  
  CONCLUSIONS
  We focus on possible biological and psychosocial factors underpinning risk for poor obstetric and gynecological outcomes in eating disorders. Understanding these factors may improve both our understanding of the reproductive needs of women with eating disorders and their medical outcomes. We also highlight the importance of building multidisciplinary teams to provide comprehensive care to women with eating disorders during the reproductive years.
authors.affiliation: Department of Psychiatry, University of North Carolina-Chapel Hill Chapel Hill, North Carolina.
authors.forename: M C
authors.initials: MC
authors.lastname: Kimmel
authors.affiliation: Department of Psychiatry, University of North Carolina-Chapel Hill Chapel Hill, North Carolina.
authors.forename: E H
authors.initials: EH
authors.lastname: Ferguson
authors.affiliation: Department of Psychiatry, University of North Carolina-Chapel Hill Chapel Hill, North Carolina.
authors.forename: S
authors.initials: S
authors.lastname: Zerwas
authors.affiliation: Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.|Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: C M
authors.initials: CM
authors.lastname: Bulik
authors.affiliation: Department of Psychiatry, University of North Carolina-Chapel Hill Chapel Hill, North Carolina.
authors.forename: S
authors.initials: S
authors.lastname: Meltzer-Brody
mesh_terms: D000856:Anorexia Nervosa / Q000150:complications*; D052018:Bulimia Nervosa / Q000150:complications*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*
keywords: anorexia nervosa; binge eating disorder; bulimia nervosa; fertility; gynecology; multidisciplinary; obstetrics; perinatal mood disorders; postpartum; pregnancy