Relapses in eating disorders often occur in the postpartum period [46-50, 55]. Moreover, the rate of PPD in women with eating disorders is high (see Chap. 19, "Postpar-tum Depression and the Role of Nutritional Factors"). Changes in estrogen status and estrogen-beta-receptor function or other gene-nutrient interactions may be responsible for observed relapses. The registered dietitian should work closely with the patient toward the end of pregnancy to set realistic goals for dietary intake, weight loss, eating behaviors, and expectations during lactation.
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