Essstörungen in der Schwangerschaft

In Schwangerschaft und postpartaler Phase kommt es zu tiefgreifenden körperlichen, hormonellen und psychosozialen Veränderungen, die das Risiko für die Entstehung, Verschärfung oder Wiederkehr von Essstörungen erhöhen können. Dieser Beitrag behandelt wichtige Aspekte veränderten Essverhaltens mit Bezug zur Schwangerschaft und stellt dar, wie eine zeitnahe, adäquate Unterstützung und Behandlung der Betroffenen ermöglicht werden können.

Kernaussagen

• Essstörungen treten bei etwa 4,3% der Schwangeren auf, wobei insbesondere ehemals Betroffene eine Hochrisikogruppe darstellen.

• Die Schwangerschaft und die postpartale Phase sind durch tiefgreifende körperliche, hormonelle und psychosoziale Veränderungen geprägt, die das Risiko für die Entstehung, Verschärfung oder Wiederkehr von Essstörungen erhöhen können.

• Besonders das Körperbild, der Umgang mit Gewichtszunahme und der Druck, die vorherige Körperform wiederzuerlangen, wirken als zentrale Risikofaktoren in allen Phasen, von der Kinderwunschzeit bis nach der Geburt.

• Essstörungen können bei Frauen zu Zyklusstörungen und Unfruchtbarkeit führen, wobei hormonelle Ungleichgewichte und ein gestörtes Essverhalten häufig Ursachen sind, die auch das Risiko von Schwangerschaftskomplikationen erhöhen.

• Frauen mit Essstörungen haben ein höheres Risiko für Schwangerschaftskomplikationen wie Frühgeburten, Fehlgeburten, Anämie und Hyperemesis gravidarum, wobei diese Risiken je nach Art der Essstörung variieren.

• Das Stigma und die Scham im Zusammenhang mit Essstörungen stellen wesentliche Hürden für eine offene Kommunikation und die Inanspruchnahme therapeutischer Hilfe dar. Behandler*innen sollten daher eine sensible und wertschätzende Ansprache wählen, Stigmatisierungen vermeiden und mutig, aber einfühlsam, mögliche Essstörungen direkt thematisieren, um eine frühzeitige Unterstützung zu ermöglichen.

• Der EAT-8-Fragebogen dient der Erfassung von Einstellungen zum Essverhalten und Körpergewicht und kann als Grundlage für die interdisziplinäre Behandlung von schwangeren Frauen mit Essstörungen dienen. Bei positivem Screening sind eine umfassende Diagnostik und ggf. eine leitliniengerechte therapeutische Begleitung notwendig.

Schlüsselwörter

Essstörung - Schwangerschaft - präpartale Gesundheit - Kinderwunsch - Psychotherapie

Publikationsverlauf

Artikel online veröffentlicht:
14. November 2025

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