Navigating the Challenges of Eating Disorders During Pregnancy: Risks, Support, and Solutions

Eating disorders during pregnancy are an important but often overlooked issue that can have serious consequences for both the mother and the developing baby. Pregnancy is typically seen as a time when a woman is expected to focus on nurturing her body and the growing fetus. However, for those already struggling with eating disorders such as anorexia nervosa, bulimia nervosa, or binge eating disorder, this period can bring about additional challenges and risks. Understanding and managing these risks requires specialist knowledge in maternal and perinatal health, which is why healthcare professionals can benefit from further education, such as our RCPI Diploma Diploma in Obstetrics and Gynaecology.

Risks to the Mother and Baby 

For the mother, eating disorders can exacerbate physical and mental health problems during pregnancy. Malnutrition, dehydration, and electrolyte imbalances, which are common in individuals with anorexia or bulimia, can lead to complications such as preterm labor, high blood pressure, or organ dysfunction. Additionally, pregnancy may trigger or intensify anxiety, depression, or obsessive behaviors, making it harder for the mother to manage her health. According to a study conducted and published by Sollid, Clausen and Maimburg entitled ‘The first 20 weeks of pregnancy is a high-risk period for eating disorder relapse’ , 25% percent of women who had been in recovery from an eating disorder relapsed, with 20 relapsing within the first 20 weeks. (Sollid et al, 2021).  

The baby is also at risk due to the potential for inadequate nutrition. Malnutrition can hinder fetal development, leading to low birth weight, developmental delays, and, in severe cases, miscarriage or stillbirth. Babies born to mothers with eating disorders may also experience long-term health issues, including learning difficulties or delayed motor skills. 

Psychological Factors and Pregnancy 

Pregnancy often brings heightened concerns about body image, weight gain, and changes in physical appearance, which can be particularly triggering for individuals with eating disorders. The pressure to gain weight during pregnancy in order to support the baby’s growth may lead to intense feelings of anxiety or guilt, exacerbating the cycle of disordered eating behaviors. 

Additionally, women with a history of eating disorders may struggle with societal expectations around “ideal” pregnancy bodies. This can make it difficult to navigate the physical changes that come with pregnancy, leading some to either restrict food intake or engage in unhealthy compensatory behaviors like excessive exercise or purging. 

Addressing the Issue 

It’s essential for healthcare providers to be aware of the potential for eating disorders during pregnancy and screen for them early. Prenatal care should not only focus on the physical well-being of the mother and baby but also include mental health support. Counseling, therapy, and specialized nutrition plans can be key elements in managing eating disorders in pregnancy. Additionally, creating a supportive and non-judgmental environment where the mother feels understood and empowered is critical to recovery. For healthcare professionals looking to enhance their expertise in maternal healthcare, our Diploma in Obstetrics and Gynaecology provides essential training in antenatal and postnatal care, equipping them to identify and manage conditions like eating disorders during pregnancy.

However, according to ‘A systematic review of the clinical practice guidelines for the assessment, management and treatment of eating disorders during the perinatal period’ which was conducted by Ecob, C., Smith, D.M., Tsivos, Z. et al., of the 17 records eligible for inclusion in the review, while most were consistent with the required recommendations for treatment of an eating disorder during pregnancy, the recommendations would require further contextualisation, ‘to allow them to be operationalised and implemented within services.’ (Ecob, C. et al, 2025) 

To facilitate this inconsistency, partners, friends, and family members should be educated on the signs of eating disorders and encouraged to provide emotional support without judgment. This is especially crucial in reducing isolation and creating a safe space for the woman to address her eating behaviors. 

Conclusion 

Eating disorders during pregnancy present complex challenges that require a multifaceted approach, combining medical care with psychological and emotional support. By recognizing the risks, understanding the underlying psychological factors, and offering comprehensive care, we can help ensure better outcomes for both mothers and their babies. More research and awareness in this area is needed to ensure that women with eating disorders receive the care they deserve during an already challenging period of time. 

What are your thoughts on how society can better address eating disorders during pregnancy, or how healthcare providers can support pregnant women struggling with these challenges? 

If you are interested in learning more about Obstetrics and Gynaecology, enquire about our Professional Diploma in Obstetrics and Gynaecology with The Royal College of Physicians Ireland 

References 

1. Ecob, C., Smith, D.M., Tsivos, Z. et al. A systematic review of the clinical practice guidelines for the assessment, management and treatment of eating disorders during the perinatal period. BMC Pregnancy Childbirth 25, 82 (2025). https://doi.org/10.1186/s12884-024-06995-x 

2. Micali, N., Treasure, J., Simonoff, E. (2007). Eating disorders symptoms in pregnancy: A longitudinal study of women with recent and past eating disorders and obesity, Journal of Psychosomatic Research, 63(3), 297-303. https://doi.org/10.1016/j.jpsychores.2007.05.003. 

3. Sollid, C., Clausen, L., & Maimburg, R. D. (2021). The first 20 weeks of pregnancy is a high-risk period for eating disorder relapse. International Journal of Eating Disorders, 54(12), 2132–2142. https://doi.org/10.1002/eat.23620