How to Manage an Eating Disorder in Pre-pregnancy, Pregnancy, and the Postpartum Period
Amy Ostroski, MS, RD, CLC
The thought of having a baby can be joyful and life-changing. For so many people, it can also be a time when intense emotions come up - especially for people who have struggled with, or continue to struggle with, disordered eating.
Your body will go through changes, there will be a focus on weight and body that can feel very different, and possibly overwhelming. It might feel like everyone has an opinion on what you should be eating and when, and you may notice the desire to do everything “right”.
Wow, what a challenging time!
Many people who are considering pregnancy think about their nutrition - Is it “good enough”? How did the way I ate in the past influence my ability to become pregnant? What if I struggled with eating, body image, disordered thoughts or behaviors? If you experience this, you are NOT alone!
What physical and emotional changes happen during pregnancy?
Pregnancy can bring unique challenges if you're managing an eating disorder or if you have had a history of eating disorders and disordered eating. The natural changes in your body shape and weight during this time can sometimes increase anxiety or make certain symptoms feel more intense.
Rapid body changes:
Gaining weight - even while growing another human - can be deeply distressing (even if you’ve never had any thoughts or concerns about body image before)
Loss of control
Pregnancy can feel unpredictable, which may lead some to use food or exercise as a way to regain a sense of control or stability
Diet culture and stigma
The societal pressure to have a “perfect” pregnancy and “bounce back” afterward can introduce or fuel harmful behaviors
Medical body-phobia:
People in larger (or smaller) bodies may be more likely to face judgment or pressure about their diet during pregnancy, increasing the risk of disordered eating, or triggering a past ED
You May Also Experience
Increased body checking and comparing your body to other pregnant people - often without considering that each pregnancy is unique and varies greatly based on stage of pregnancy, body type, number of previous pregnancies, etc.
Internal criticism about cravings - and judgment about “giving in” to them
Intense emotions about weight and body changes
Feelings of isolation
How common are eating disorders during pregnancy?
Eating disorders in pregnant people are more common than many realize, and they can affect anyone—regardless of age, body size, race, gender identity, or socioeconomic status. Compassion and awareness are essential to supporting your physical and mental well-being before, during, and after pregnancy.
How do eating disorders affect fertility?
Prior to pregnancy, an untreated eating disorder can:
Upset your hormone balance, making it more difficult to get pregnant
Create vitamin and mineral deficiencies
Upset your sleep
Make caring for yourself feel more difficult
How do untreated eating disorders impact pregnancy and postpartum?
PPD/PPA (postpartum depression or anxiety)
Nutrient deficiencies
Heart problems
Miscarriage or preterm labor
How does an eating disorder affect the baby during pregnancy?
Babies can be affected by their birthing parent’s untreated eating disorders, too. Some complications may include:
Low birth weight
Slowed fetal growth
Developmental delays
Feeding issues after birth
It's important to have close nutritional monitoring throughout your pregnancy, along with continued support after your baby is born. We're here to help you stay healthy while supporting both your well-being and your baby's development. Recovery is possible, and getting help before and during pregnancy, and getting continued treatment after birth, can lead to better outcomes for you and your baby.
What are the signs you need support?
If you or someone you love is pregnant and experiencing any of the following, it might be time to reach out for help:
Anxiety or dread around meals or weight checks
Extreme guilt after eating
Obsessive thoughts about food, calories, or exercise
Body image distress that interferes with daily life
Using harmful behaviors to control weight (e.g., restriction, purging, over-exercising)
Isolating yourself from others due to body or food concerns
Early support can make a big difference. You matter and should receive the care and support you deserve.
Experience Recovery with a pregnancy dietitian:
It’s never too early to seek support - you CAN and WILL be able to heal from an ED. Support may look like:
Working with an eating disorder-informed therapist
Partnering with a registered dietitian who understands perinatal nutrition
Joining a support group (in-person or virtual) or meal support sessions
Seeking prenatal treatment from an ED-informed OB or midwife
If you’ve previously recovered, or are in active recovery from an eating disorder, consider creating a plan with your support team in early pregnancy or before becoming pregnant. It’s never too early! Staying connected to your care team can help prevent relapse and can offer additional comfort and support.
You Are Not Alone
Pregnancy is a challenging and vulnerable time, and struggling with disordered eating doesn’t make you a “bad” parent—it makes you human. Seeking help is a sign of strength.
Remember, EVERY body is different, and comparing yourself to others makes it harder for the amazing, strong, wonderful person you are to shine.
If you or someone you love is navigating challenges with food, body image, or eating behaviors at any stage—before pregnancy, during, or postpartum—you deserve compassionate, specialized care. Eating disorders can affect fertility, complicate pregnancy, and impact postpartum recovery, but you don’t need to wait for things to worsen before seeking support. Treatment isn’t about being “sick enough”—it’s about reclaiming your well-being and nurturing both your body and mind.
Whether you’re planning for pregnancy, currently expecting, or adjusting to life after birth, questioning whether your struggles are 'serious enough' is itself a sign to explore help. You deserve a relationship with food and your body that feels peaceful—not burdensome.
At Side By Side, we offer holistic, evidence-based support for individuals across the perinatal journey. Our approach centers on self-compassion, body trust, and individualized care. Together, we’ll work to restore nourishment, support emotional resilience, and help you build a life where both you and your baby can thrive.
Resources:
Author Note: This post is not a substitute for medical advice. If you are in crisis, please seek professional help immediately.