Background/Aim: Literature on disordered eating (DE) in gestational diabetes (GDM) is limited. We assessed DE psychopathology at GDM diagnosis in an ethnically diverse population using a validated questionnaire.
Methods: Consenting English‑literate women completed the Eating Disorders Examination Questionnaire (EDE‑Q) before GDM education. EDE‑Q scores indicating clinically significant global DE psychopathology (≥2.8) and subscales indicating high severity (≥4.0) were compared with Australian community norms for non‑pregnant young women¹ using Chi‑square or Fisher tests. DE behaviours were classified as “any” or "regular" if ≥1 or ≥4 episodes respectively occurred over the previous 28 days.
Results: Of 355 eligible women, 143 (40.2%) participated: mean (SD) age 32.0 (5.3) years, median (IQR) pre‑pregnancy BMI 27.5 (9.0) kg/m², prior GDM 22.7%. Ethnic distribution was 31.9% Anglo-Australian, 25.4% South-Asian, 14.5% Middle-Eastern, 13.8% South-East-Asian and 14.4% other.
Compared with community norms¹, fewer women with GDM exceeded the EDE‑Q global psychopathology threshold (7.7% vs 17.0%, p=0.003) and all subscales: restraint (0.7% vs 5.0%, p=0.019), eating concern (0.0% vs 3.0%, p=0.022), shape concern (11.2% vs 18.0%, p=0.036), and weight concern (5.6% vs 10.0%, p=0.081). Among Anglo-Australian participants, 13.3% exceeded the global threshold compared with 4.2% of Non‑Anglo-Australian women. Subscale scores were consistently lower in the latter group.
In contrast, DE behaviours were more frequent in this GDM cohort, including any objective binge eating (OBE) (41.6% vs 17.3%, p<0.0001), self‑induced vomiting (9.0% vs 3.0%, p=0.006) and laxative misuse (5.6% vs 1.8%, p=0.025). Only compulsive exercise was less frequent (22.2% vs 28.2%, p<0.001). Regular OBE were more than double the community norm (24.7% vs 10.6%, p<0.0001). DE behaviours were consistently higher among Non‑Anglo verses Anglo-Australian women, including any OBE (45.3% vs 26.1%) and regular OBE (26.6% vs 13.0%).
Conclusions: Compared with community norms, women with GDM showed lower DE psychopathology scores, yet higher rates of DE behaviours, particularly binge eating. These patterns were consistently more pronounced among Non‑Anglo-Australian participants, suggesting that the EDE‑Q may not fully capture DE psychopathology in culturally diverse populations. The high binge eating rate may warrant targeted attention within GDM care.
1 Mond JM et al. Behav Res Ther 2006;44:53–62