Eating Disorders in Pregnancy and Postpartum: Signs, Screening, and Why Early Help Matters
On National Eating Disorders Screening Day, take a moment to check in with yourself.
When no one talks about the silent battles with weight gain, body image, and eating disorders during pregnancy, I talk about it. Before I became a perinatal therapist, I worked with adults at a nationally known eating disorder treatment facility.
I began to see parents cycling in and out of treatment, and over time I saw how pregnancy, postpartum, and parenthood can contribute to the development, maintenance, or relapse of an eating disorder. My mission to raise awareness started when I almost relapsed after becoming a mother myself.
Why Early Detection of Eating Disorders Matters
On average, people wait 2.5 years to seek help for anorexia nervosa and 6 years for binge eating disorder. During that time, serious medical and psychological problems can develop, making recovery harder. Getting help within the first three years of symptoms increases the chances of recovery.
Not meeting the full criteria for a diagnosis doesn't mean it isn't serious. Disordered eating can still take a toll and often gets worse over time. You don't need a diagnosis to ask for help.
How Common Are Eating Disorders in Pregnancy and Postpartum?
According to the American Pregnancy Association, eating disorders affect about 7 million American women each year and tend to peak during childbearing years.
The National Alliance for Eating Disorders reports that 12% of pregnant people experience eating disorder symptoms during pregnancy or postpartum.
Eating disorders can happen at any point in life, but they often follow a "perfect storm" of biology, environment, family history, and personal history, such as trauma.
Common Triggers for Eating Disorders in Pregnancy
Triggers look different for everyone, but may include:
• Morning sickness and vomiting
• Perceived changes in weight and body shape
• Extra attention to nutritional intake
• An emphasis on exercise and activity
• Loss of control, including bodily control
• Changes in ability and mobility
Signs of an Eating Disorder During Pregnancy
Excessive or compulsive exercise, or unwillingness to change an exercise routine
Restricting food intake or obsessive calorie counting
Self-induced vomiting or laxative use
Shame or guilt about weight gain
Weighing yourself several times a day, or other body-checking
Fear or intense distress about gaining weight
Avoiding doctor's appointments
Feeling disconnected from the baby growing inside you
General Eating Disorder Warning Signs (per NEDA)
Behavioral
Changes in eating behaviors, or eating only limited foods or textures
Frequent mirror checking for perceived flaws
Withdrawing from friends and avoiding eating in public
Extreme mood swings
Excessive or compulsive exercise
Emotional
Preoccupation with weight loss, food, calories, and dieting
Extreme concern with body size and shape
Shame, guilt, and despair after binge eating episodes
Low self-esteem
Fears of choking or vomiting
Feeling out of control or ashamed when eating
Physical
Significant weight fluctuations, up or down
Gastrointestinal complaints
Dizziness upon standing
Difficulty concentrating or sleeping
Dental, skin, hair, and nail health issues
Why We Need to Screen for Eating Disorders in Pregnancy and Postpartum
Struggles with food and body, whether or not they meet diagnostic criteria, rarely exist on their own. They commonly co-occur with:
Depression
Anxiety
PTSD
OCD
Bipolar disorder
That's because hyperfocus on food and body is often a way of coping with other challenges.
Perinatal mood and anxiety disorders (PMADs) are the number one complication of pregnancy and postpartum, and research suggests 1 in 5 birth parents experience one or more. The real number is likely higher because of stigma and underreporting. If PMADs are that common and eating disorders so often co-occur with them, there is a strong chance that struggles with food and body are being missed.
5 Myth-Busting Facts About Eating Disorders
Anyone can be affected. Eating disorders impact people of all ages, gender identities, races, religions, ethnicities, sexual orientations, body shapes, and weights.
BIPOC individuals are underdiagnosed. They experience eating disorders at the same or higher rates as white individuals but are half as likely to be diagnosed. Racial trauma, discrimination, microaggressions, and navigating multiple cultures can all affect your relationship with food and body.
Men are affected, too. About 1 in 3 people with an eating disorder identify as men or boys, and rates are rising faster in men than in women. The myth that only women are affected delays recognition.
You can't tell by looking. 94% of people with eating disorders live in average or higher weight bodies, and only 6% are medically underweight.
No one chooses an eating disorder. They are bio-psycho-social illnesses shaped by genetic, biological, environmental, and social factors.
Take the Free Eating Disorder Screening
NEDA's screening tool is free, confidential, and quick. It helps you understand your risk and connects you with resources. This National Eating Disorders Screening Week, don't wait. Take the screening at nationaleatingdisorders.org.
Work With Me
I support pregnant, postpartum, and parenting clients in Washington state with eating disorders, body image, food guilt, birth trauma, and perinatal mental health, using EMDR, IFS, and DBT. You deserve support now, not after things get worse.
Book a free 15-minute intro call →here
Support Resources
NEDA screening tool: nationaleatingdisorders.org
National Alliance for Eating Disorders helpline: 866-662-1235 (please verify before publishing)
Postpartum Support International HelpLine: 800-944-4773
In a crisis, call or text 988
Frequently Asked Questions About Eating Disorders in Pregnancy and Postpartum
Can you develop an eating disorder during pregnancy?
Yes. Pregnancy, postpartum, and parenthood can contribute to the development, maintenance, or relapse of an eating disorder. The National Alliance for Eating Disorders reports that 12% of pregnant people experience eating disorder symptoms during pregnancy or postpartum.
Is it normal to feel anxious about weight gain during pregnancy?
Many people have mixed feelings about body changes. But intense distress, shame, or guilt about weight gain, along with restricting food, compulsive exercise, or weighing yourself several times a day, are signs it's worth reaching out for support. You don't need a diagnosis to ask for help.
What are the signs of a postpartum eating disorder?
The signs often overlap with those in pregnancy: restricting food, obsessive calorie counting, excessive or compulsive exercise, frequent body checking, and shame or guilt around eating. You may also notice withdrawing from others or avoiding eating in front of them. Some people feel disconnected from their body or their baby.
Can disordered eating be serious if I don't meet the criteria for an eating disorder?
Yes. Disordered eating can still take a serious toll on your physical and mental health, and it often gets worse over time. Reaching out at the first signs can make a big difference.
Do you have to be underweight to have an eating disorder?
No. Eating disorders affect people of all body shapes and sizes. About 94% of people with eating disorders live in average or higher weight bodies, and only 6% are medically underweight.
Why are eating disorders missed during pregnancy and postpartum?
Struggles with food and body rarely exist on their own. They often co-occur with depression, anxiety, PTSD, OCD, and bipolar disorder. Since 1 in 5 birth parents experience a perinatal mood or anxiety disorder, and mental health conditions are often underreported because of stigma and shame, battles with food and body can easily go unnoticed without routine screening.
How do I know if I'm at risk for an eating disorder?
NEDA's free screening tool is a quick, confidential first step. It helps you understand your risk and connects you with resources. You can take it at nationaleatingdisorders.org.
When should I reach out for help?
As early as possible. People wait an average of 2.5 years to seek help for anorexia nervosa and 6 years for binge eating disorder, and getting help within the first three years of symptoms increases the chances of recovery. If you're wondering whether it's time, it is.
Do you offer therapy for eating disorders and body image concerns in pregnancy and postpartum?
Yes. I work with pregnant, postpartum, and parenting clients in Washington state on eating disorders, body image, and food guilt, using EMDR, IFS, and DBT. Book a free 15-minute intro call →HERE!
