Binge-spectrum symptoms in their association with higher gestational weight gain.

OBJECTIVE: Gestational weight gain (GWG) above or below recommendations is common and has implications for parent and infant health. Bulimia nervosa and binge-eating disorder during pregnancy have been associated with higher GWG. Yet, little research has examined the associations between binge-spectrum symptoms and GWG. Likewise, few interventions exist to adequately prevent GWG. The current study investigated a broad range of predictors of GWG, with the goal of identifying potentially modifiable risk factors. METHOD: We conducted secondary data analyses of a subsample of individuals from the Alberta Pregnancy Outcome and Nutrition (APrON) longitudinal cohort study. Multinomial logistic regression estimated the odds of gestational weight gain (GWG) outside of Institute of Medicine (IOM) recommendations and linear regression was used to examine total GWG continuously. RESULTS: Of the 1644 participants included, 848 (51.6%) exceeded the IOM's guidelines for GWG, and 272 (16.5%) gained below these recommendations. Binge-spectrum symptom symptomatology during pregnancy was not associated with exceeding GWG recommendations after accounting for post-secondary education, identifying as European Canadian, and higher pre-pregnancy body mass index (BMI). However, greater self-reported binge-spectrum symptomatology during pregnancy was associated with higher total GWG after accounting for age, parity, and pre-pregnancy BMI. CONCLUSIONS: In addition to replicating identified predictors of higher GWG, we found that greater binge-spectrum symptomatology was associated with higher total GWG. These findings suggest that routine screening for eating pathology during pregnancy may identify those at risk for excess GWG. PUBLIC SIGNIFICANCE: Gestational weight gain (GWG) outside of recommended ranges is associated with adverse outcomes. Little work has examined the associations between eating disorder symptoms and GWG. This study found that bulimia and binge-eating symptoms were uniquely associated with higher GWG beyond known risk factors. These findings support routine screening of eating disorder symptoms and interventions to help individuals gain within GWG recommendations during pregnancy.

Pediatric Avoidant-Restrictive Food Intake Disorder and gastrointestinal-related Somatic Symptom Disorders: Overlap in clinical presentation.

Certain presentations of Avoidant/Restrictive Food Intake Disorder (ARFID) and Somatic Symptom and Related Disorders (SSRDs) have conceptual overlap, namely, distress and impairment related to a physical symptom. This study compared characteristics of pediatric patients diagnosed with ARFID to those with gastrointestinal (GI)-related SSRD. A 5-year retrospective chart review at a tertiary care pediatric hospital comparing assessment data of patients with a diagnosis of ARFID (n = 62; 69% girls, Mage = 14.08 years) or a GI-related SSRD (n = 37; 68% girls, Mage = 14.25 years). Patients diagnosed with ARFID had a significantly lower percentage of median BMI than those with GI-related SSRD. Patients diagnosed with ARFID were most often assessed in the Eating Disorders Program, whereas patients diagnosed with an SSRD were most often assessed by Consultation-Liaison Psychiatry. Groups did not differ on demographics, psychiatric diagnoses, illness duration, or pre-assessment services/medications. GI symptoms were common across groups. Patients diagnosed with an SSRD had more co-occurring medical diagnoses. A subset (16%) of patients reported symptoms consistent with both diagnoses. Overlap is observed in the clinical presentation of pediatric patients diagnosed with ARFID or GI-related SSRD. Some group differences emerged, including anthropometric measurements and co-occurring medical conditions. Findings may inform diagnostic classification and treatment approach.