Today "Good Morning America" shared the story of Beth Jones, who struggled with an eating disorder that continued during her three pregnancies. Jones, who is featured on a special program airing tonight on the Discovery Health called "'I'm Pregnant and ... I Have an Eating Disorder," has spent much of her life obsessed with diet and exercise.
While Jones gave birth to healthy babies, "GMA" medical contributor Dr. Marie Savard says having an eating disorder during pregnancy can pose serious risks.
"Most women with eating disorders have a difficult time getting pregnant, and when they do there are risks," Savard said.
But there is also good news. Savard says many women with eating disorders do actually get better during pregnancy. They often feel they are eating for the good of the baby and that concern outweighs the other issues that lead to the disordered eating. But others get depressed over the changes in their body shape and image, and may actually have more disordered eating. Many fall somewhere in between.
Savard has advice on pregnancy and weight gain, and says the good news is that if women start eating well when they are pregnant, their history of eating disorders shouldn't have a negative effect on their baby.
Underweight or premature baby: Women who eat too little and don't gain weight during pregnancy risk having an underweight or even a premature baby.
Heart abnormalities in mothers: Women who purge or use laxatives and diuretics may experience dehydration, electrolyte imbalance and heart rhythm abnormalities. They can also create these risks for their babies.
Postpartum depression: There's a high risk of postpartum depression in women who have or have had eating disorders.
On average, Savard says healthy women should gain between 25 and 35 pounds.
The rate of weight gain, she says, should be approximately "a pound every month for the first trimester and a pound every week thereafter."
"This is a daunting task" for women who have struggled with eating disorders, she said.
If a women doesn't gain enough weight during the pregnancy, she says the chances are high the baby will be small or premature. A mother's weight gain correlates directly with a healthy baby.
The Institute of Medicine also says that women of normal weight should gain 25 to 35 pounds during pregnancy, and that mothers-to-be who are underweight when they become pregnant should gain 28 to 40 pounds.
CLICK HERE for the Institute of Medicine's guidelines on weight gain during pregnancy for every weight category.
Designate a health buddy to support you through your pregnancy.
"Teamwork really matters," Savard said. She advises choosing "someone who really helps keep you vigilant" to attend appointments with you and track your progress.
Tell your ob-gyn about your history: It's important that before you get pregnant you alert your ob-gyn to your history. You will need more careful monitoring during pregnancy.
"You've got to talk about your eating habits," Savard said.
Meet regularly with a nutritionist: It's best to see a nutrition specialist who's experienced with eating disorders throughout your pregnancy.
"You need to work with a nutritionist, before pregnancy, ideally," Savard said.