May 28, 2023 • 7 min read

Eating Disorders During Pregnancy: Managing Anorexia, Bulimia, & More

Medically Reviewed by Kim Langdon, MD on 05.31.23
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One of the most important ways a pregnant mother can care for herself and her baby during pregnancy is to eat healthy, well-balanced meals. This supports her health as well as the developmental needs of her child. Having an eating disorder can make this fundamental task much more difficult.

Anorexia and bulimia are common eating disorders that can arise during and after pregnancy in some women. While anorexia involves a lack of eating, bulimia involves overeating and purging. These eating disorders can be detrimental to both the health of the mom and her fetus.

This guide will discuss common characteristics of eating disorders, the complications of eating disorders during pregnancy, how to manage an eating disorder during pregnancy, and where to find support. We will also answer common concerns regarding eating disorders and their effect on mother and child.

Eating disorders that can impact your pregnancy

Recent research suggests almost 8% of pregnant women suffer from an eating disorder. Some of the more prevalent eating disorders that women may deal with before, during, or after pregnancy include:

  • Anorexia nervosa. This eating disorder is characterized by an obsession with weight and food consumption. People suffering from anorexia often use starvation, extreme exercise, and other unhealthy measures to lose weight or remain underweight.
  • Bulimia nervosa. With bulimia, sufferers often force themselves to vomit (purge) after eating in an effort to lose weight or remain underweight.
  • Binge eating. When someone binge eats, they consume excessive amounts of food and are unable to stop or control themselves. 

Complications of eating disorders during pregnancy

There can be complications to not eating enough during pregnancy for all women. When a pregnant mother has an active eating disorder, it can be even more difficult for vital nutrients and vitamins to be delivered to her fetus. This can result in dire consequences.

According to the American Pregnancy Association, those consequences include: 

  • Death of the fetus. Without proper nutrition, calories, and vitamins, the fetus may not be able to sustain life. 
  • Delayed growth. Lack of the proper nutrients can stall growth and development.
  • Respiratory problems. Lung development can be impacted significantly by delayed growth.
  • Low birth weight. Inadequate weight at birth can make the newborn susceptible to colds, infections, and illness.
  • Birth defects. If the mother is taking medications to help her purge, or restrict her eating, those medications may harm her baby and potentially cause birth defects.

Pregnant women with eating disorders can experience serious symptoms and life-threatening consequences as well. Complications for the pregnant mother can include:

  • Cardiac issues. Including an irregular heartbeat.
  • Electrolyte imbalance. Can cause bladder and kidney issues.
  • Gastrointestinal problems. Can include constipation, gallbladder issues, esophageal damage, stomach lining damage, and more.
  • Osteoporosis. The lack of proper nutrients and calories can cause brittle bones, making women more susceptible to fractures.
  • Preeclampsia. This is a serious condition, characterized by high blood pressure, often requiring bed rest.
  • Mood disorders. Eating disorders can lead to other serious issues such as depression, anxiety, and post-partum depression.
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How to manage an eating disorder during pregnancy

Getting the right number of calories while pregnant is imperative for the mother and her fetus’s health. Optimal health will improve the mother’s mental and physical well-being and help contribute to a healthy baby and a potentially easier delivery.

That’s why it’s so important to manage an eating disorder throughout pregnancy.

One of the most important things you can do to manage your eating disorder is to tell your healthcare providers about it. An eating disorder is both a mental health disorder and a medical condition and therefore, requires both psychological and medical support.

Here are some strategies for managing an eating disorder while pregnant:

  • Work with a prenatal nutritionist. A prenatal nutritionist can devise a nutritional plan to support you and your baby’s health. A nutritionist can also help you learn about proper portion sizes, how often you should eat, and how to prep and plan meals. They may recommend vitamins or nutritional supplements to help you get all the nutrients you need. You may also want to consider working with a nutritionist specializing in eating disorders.
  • Work with a therapist trained and experienced in eating disorders. Eating disorders can be viewed as a type of compulsive addiction or preoccupation that requires specialized knowledge and training.
  • Know your triggers. If “weighing in” during your prenatal office visits causes anxiety, tell your provider you do not want to know your weight. If morning sickness is a trigger, manage your distress with support from your therapist.
  • Keep a journal to record your anxieties and fears. This is a safe place to acknowledge and work through your eating disorder.
  • Plan your meals ahead of time. It can relieve anxiety to know what you will be eating. You can plan your meals three days at a time and allow for flexibility within those three days. If you plan on eating out, review the menu ahead of time so you can help diminish food anxiety and allow yourself time to choose a nutritious option.
  • Allow yourself some mistakes and move on. No need to punish yourself or give up if you have a relapse. Forgive yourself and make healthy choices moving forward.

>> Read more: How much does eating disorder treatment cost? With & without insurance

Where to find support for managing eating disorders during pregnancy

If you have had an eating disorder in the past and are trying to get pregnant, are currently pregnant, or are a new mother, a prenatal nutritionist can give you the educational support you need to nourish your body.

Prenatal nutritionists can help you devise meal plans that are nutritional and appetizing. Often when people think of nutritionists, they fear they won’t be able to eat food they enjoy. This is a common misconception.

Most nutritionists believe that healthy eating is larger than nutrition alone, and they consider culture, entertainment, celebrations, and more when creating meal plans. Part of a nutritionist’s job is to help people live in harmony with food.

If you would like to find a prenatal nutritionist that can support you as you manage an eating disorder during pregnancy, Zaya Care can match you with one. Browse options and filter by visit type, insurance accepted, and more to find your fit.

Another professional who can provide comprehensive support during your pregnancy is a mental health therapist. A therapist can provide a safe place to discuss the causes and effects of an eating disorder. They can provide strategies for coping with the stress of pregnancy so that you are able to follow the nutritional advice of your medical providers.

Zaya Care has a network of mental health therapists who have experience with the issues faced in pregnancy including eating disorders. If you would like to find a therapist to support you during your pregnancy, visit Zaya Care’s provider search tool. You can filter results by location, insurance accepted, visit type, and more. 

Can I develop an eating disorder after getting pregnant?

It is possible to develop an eating disorder during pregnancy. Many women experience difficulty with their bodies changing, as these changes occur outside of their control. 

Fear of not regaining control over one’s body can intensify feelings around food and exercise. Though many pregnant women can contend with these changes without developing an eating disorder, others cannot.

Here are some factors that may contribute to the development of an eating disorder in pregnant women:

  • Gaining weight. Gaining weight can feel very uncomfortable, especially as a pregnant woman, when the weight is not evenly distributed. This discomfort may cause preoccupation with body image and trying to inhibit more weight gain.
  • Morning sickness. Loss of appetite and nausea after eating are common experiences in pregnancy. Those with a history of an eating disorder may be triggered by these conditions, reigniting their eating disorder. Morning sickness may feel like a relief and may prompt women to self-induce vomiting if they think it will make them feel better. 
  • Gestational diabetes. Gestation diabetes may contribute to hypervigilance over diet and nutrients. This preoccupation with food can lead to restrictive eating or over-monitoring of food intake.
  • Bed rest. This may invoke feelings of helplessness and potentially cause a mother to restrict her food intake in order to compensate for the lack of exercise.

If you are worried you may be developing an eating disorder as your pregnancy progresses, reach out to a mental health therapist who specializes in pregnancy-related issues. Zaya Care’s provider search tool can help you match with someone who accepts your insurance.

>> Read more: Hungry but no appetite? Possible reasons why

Can an eating disorder affect fertility?

Fertility is heavily dependent on good physical health and proper nutrition. The longer the woman has experienced the eating disorder, the more physical damage may have occurred, negatively impacting her fertility. Recovery, an ongoing process for those with eating disorders, is necessary for optimal fertility health.

Eating disorders can affect fertility in the following ways:

  • Cause hormones to fluctuate
  • In extreme cases, cause the uterus and ovaries to return to a prepubescent length and size
  • Restrict levels of vital minerals, vitamins, and nutrients
  • Cause irregular periods make timing ovulation/conception difficult

The good news is, with proper treatment of the eating disorder, fertility can often be restored. If you are thinking of getting pregnant but are struggling with an eating disorder, now is the time to seek support. 

To find a mental health therapist who can support you in your recovery from an eating disorder, visit Zaya Care’s provider search tool. It can help you match with someone who understands your unique situation, especially as you try to conceive.

Learn more about eating disorders

To learn more about eating disorders, including anorexia, bulimia, and binge eating, visit the American Psychiatric Association’s pages on eating disorders.

>> Find Help: Search for a prenatal nutritionist who can help you manage your nutrition during pregnancy

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Lauren Reynolds is a Licensed Marriage and Family Therapist and has worked with over half a dozen non-profits, including a residential facility for young mothers and their newborn babies. Lauren is also a mother to a 15-year-old boy and a 7-year-old girl, both birth center babies. She believes in inclusive maternity practices and access to quality maternal health for all. Lauren is also a culinary school graduate and professionally trained chef.