What Are the Risks of Eating Disorders During Pregnancy?

Eating disorders can affect pregnancy health. Learn the risks, complications, and ways to support both mother and baby during recovery.

Pregnancy brings enormous physical and emotional change. For someone living with maternal eating disorders, especially anorexia, bulimia, binge eating disorder, or atypical eating disorder, these changes may trigger fear, anxiety, and distress.

The perinatal period (pregnancy through postpartum) can intensify eating disorder symptoms, eating disorder guilt, and worries about weight gain. While pregnancy may motivate some toward healthier eating habits, others struggle with active anorexia nervosa, compulsive eating, purging, or weight loss behaviors that threaten maternal mental health and fetal development.

There’s no shame in struggling with an eating disorder, and help is available. Read on to learn about getting support for this condition at any time — including pregnancy.

Types of eating disorders and pregnancy symptoms

Each common eating disorder can interact with pregnancy differently:

• Anorexia nervosa: restricting food intake during a time of essential nutritional need
• Bulimia: bingeing and purging, often worsened by body image anxiety and food cravings
• Binge eating disorder / compulsive eating: overeating followed by intense guilt and shame
• Atypical eating disorder (OSFED): serious symptoms that don’t fit strict diagnosis criteria

Morning sickness may mask secret purging behaviors, while rapid body changes may worsen anxiety disorders or co-occurring perinatal depression.

Pregnancy can be a triggering time. Hormonal changes, social pressure, and physical transformation can heighten:

• Body dissatisfaction
• Anxiety disorders and intrusive thoughts
• Vulnerability to perinatal depression
• Fear of losing control over food and weight

These emotions deserve validation — not stigma.

How eating disorders affect maternal health

Eating disorders can significantly impact maternal well-being, contributing to:

• Nutritional deficiencies
• Heart complications
• Electrolyte imbalance
• Severe dehydration (especially with bulimia)
• Sleep disturbance and fatigue
• High levels of stress and anxiety disorder symptoms

These issues increase risk for maternal mental health decline, requiring early disorder treatment to protect both parent and baby.

Eating disorders and pregnancy complications

Eating disorders are linked with higher chances of dangerous pregnancy outcomes, including:

• Premature birth
• Low birth weight
• Restricted fetal growth / low gestational age for size
• Preterm labor
• Miscarriage
• Gestational diabetes (especially in compulsive eating disorders)
• Hypertensive disorders
• Placental complications affecting fetal oxygen and nutrition

Malnutrition and stress can negatively impact a developing baby’s brain, bones, and nervous system.

The risk is greatest with active anorexia nervosa or ongoing purging — but any untreated disorder can lead to complications.

Warning signs loved ones should notice

A pregnant person may hide or minimize symptoms. Red flags include:

• Skipping meals and extreme dieting
• Rapid weight loss or slow weight gain
• Excessive exercise despite medical advice
• Fear or panic around prenatal weigh-ins
• Eating alone or hiding compulsive eating
• Persistent negative feelings about the body
• Avoiding or lying about routine prenatal care

Pregnancy should never be a time to “tough it out” — maternal well-being is a medical priority.

Evidence-based treatment and support

Disorder treatment during pregnancy is possible and safe with proper support. Options include:

1. Therapy and medication

• CBT and other therapies tailored to pregnancy
• Medication—only when risks are outweighed by benefits
• Support groups where pregnant women share lived experiences

2. Talk with your healthcare provider

It’s also worth talking with healthcare providers. A collaborative team may include an OB-GYN, dietitian, therapist, psychiatrist, and perinatal specialist — ensuring safe monitoring of both physical and emotional health.

Open conversation is critical. Healthcare providers can adjust:

• How often someone is weighed
• How weight changes are communicated
• Nutritional plans based on tolerance and safety
• Dietary support emphasizing flexibility and nourishment
• Close monitoring of weight, labs, and fetal development

3. Prepare for the postpartum period

The months after birth often trigger relapse due to:

• Rapid body changes
• Breastfeeding challenges
• Sleep deprivation
• Identity and role changes

A proactive postpartum support plan can reduce risk and ensure continuity of care.

How Charlie Health can help

If you or a loved one is struggling with your mental health and could use more than once-weekly support, Charlie Health is here to help. Charlie Health’s virtual Intensive Outpatient Program (IOP) provides behavioral health treatment for people dealing with serious mental health conditions. Our expert clinicians incorporate evidence-based therapies into individual counseling, family therapy, and group sessions. With this kind of holistic online treatment, managing your mental health is possible. Fill out the form below or give us a call to start healing today.