Eating Disorders and Perinatal Mental Health
There’s a common belief that pregnancy and the postpartum period should be purely joyful, magical seasons of life. Glowing. Transformative. Fulfilling in a way that eclipses all struggle.
For women with a history of eating disorders or longstanding body image struggles, the perinatal period can be uniquely destabilizing. Pregnancy and postpartum bring rapid, visible body changes, shifts in appetite and control, identity transitions, sleep deprivation, and hormonal fluctuations. Even in recovery, these changes can reactivate old neural pathways—thoughts about restriction, fears of weight gain, urges to compensate, or a resurgence of shame around the body.
Eating disorders during pregnancy are more common than many realize, so let’s talk about what’s really happening and what support can look like.
How Common Are Eating Disorders During Pregnancy?
Eating disorders are not rare in reproductive-aged women
More than 40% of women report feeling concerned about their weight during pregnancy. By one month postpartum, nearly 75% say they are worried about weight retention, and about 70% attempt to lose weight within the first four months after giving birth. Research also suggests that approximately 15% of pregnant individuals have experienced an eating disorder at some point in their lives. Around 5% meet criteria for an eating disorder during pregnancy, and that number rises to roughly 13% in the postpartum period. (Policy Center for Maternal Mental Health)
Why the Perinatal Period Is So Vulnerable
Body Changes and Triggers
Weight gain is expected and necessary during pregnancy. For someone with a history of restriction, bingeing, or purging, this can feel destabilizing.
The postpartum body can be equally triggering:
Loose skin
Changes in breast size
Weight retention
Comments from others about “bouncing back”
Navigating the perinatal period as someone who has or had a disordered relationship with food, exercise, weight, or shape can feel like an impossible minefield.
Control, Food, and Pregnancy
Eating disorders are often intertwined with control. (PSI) Pregnancy requires:
Appetite shifts
Cravings
Medical recommendations about weight gain
Physical limitations
Postpartum adds unpredictability: feeding schedules, sleep deprivation, and new routines.
Identity Shifts
Becoming a mother can intensify perfectionism and self-criticism. Many women report:
Fear of “failing”
Comparing themselves to other mothers
Pressure to “do it all”
If identity has historically been tied to body size, discipline, or appearance, that identity disruption can be destabilizing.
Hormonal & Mood Vulnerability
The perinatal period carries increased risk for mood disorders:
1 in 5 women experience perinatal depression or anxiety.
Postpartum depression affects roughly 10–20% of new mothers.
Depression and anxiety frequently co-occur with eating disorders, increasing risk of relapse or symptom escalation.
How Eating Disorders May Present During Pregnancy or Postpartum
It’s not always obvious. Symptoms can look different in this season:
Some women temporarily improve during pregnancy (motivated by baby’s health) and relapse postpartum when external structure decreases.(Maternal Mental Health Network)
Obsessively tracking weight gain
Anxiety about prenatal appointments
Restricting certain food groups under the guise of “clean eating” aka Orthorexia
Compulsive exercise despite medical advice
Intense distress about postpartum body changes
Skipping meals while prioritizing baby’s needs
Binge eating during sleep deprivation
Purging behaviors returning after delivery
Why Early Support Matters
Eating disorders during pregnancy are associated with increased risk of:
Preterm birth
Low birth weight
Gestational complications
Increased postpartum depression
Breastfeeding challenges
But beyond medical outcomes, there is an emotional cost. A mother preoccupied with food, weight, and shame is carrying an invisible burden at a time when she needs support the most. (NIH)
The Postpartum “Bounce Back” Myth
The pressure to “get your body back” can feel immense. The expectation that a body should quickly return to its pre-pregnancy shape is deeply rooted in diet culture and narrow, unrealistic beauty standards.
Studies have shown social media often amplifies this message. (NIH)
Before-and-after photos
Workout programs marketed to new moms
Language about “fixing” the body
But the postpartum body is not a problem to solve. It is a body that has built, birthed, and is potentially feeding a human being. (Psychology Today)
Recovery in this season often means shifting the focus from appearance to function:
Is my body nourished?
Do I have energy?
Am I healing?
Can I be present?
What Support Can Look Like
Therapy: Cognitive-behavioral therapy (CBT) for eating disorders, Acceptance and Commitment Therapy (ACT), Compassion-focused therapy and EMDR may be helpful when trauma intersects with body or birth experiences
Nutritional support: Working with a dietitian can ensure proper nutrition for both parent and baby
Support groups: Connecting with others facing similar challenges can provide validation and encouragement
Medical care: Regular check-ins with healthcare providers can monitor physical and mental health
Partner and Family Involvement: Partners and family members can play an important role by learning the signs of relapse, avoiding body-focused comments, and encouraging gentle support rather than criticism.
You Are Not Alone and Support is Available
If you are struggling with an eating disorder and also pregnant or postpartum, it is important to get help. You are not alone. And relapse does not mean failure.
Our practice offers perinatal and postpartum mental health support, including trauma-informed therapy and EMDR. If body image distress, anxiety, birth-related trauma, or identity shifts are surfacing during this season, we would be honored to walk alongside you. And if more specialized eating disorder treatment is indicated, we can help guide you toward providers who focus specifically in that area. Reach out to schedule a consultation.
Resources and Next Steps
National Association of Anorexia Nervosa and Associated Disorders (ANAD): Offers a helpline, online chat, and directory of treatment providers.
Project Heal: Focuses on providing access to treatment for those with eating disorders.
MGHospital Center for Women’s Mental Health: Research-informed guidance and resources for perinatal mental health conditions, including anxiety and postpartum depression.
Postpartum Support International (PSI): Free support groups, helplines, and provider directory for perinatal mood and anxiety disorders.
Are you concerned you might be struggling with an eating disorder? The National Center of Excellence for Eating Disorders (NCEED) offers a Free Screening Tool for Eating Disorders.
Are you looking for an eating disorder treatment provider? Find treatment in your area or online.
Are financial barriers preventing you from seeking the support you need? Learn more about free and low cost support options to connect with others and provide tools to promote recovery.
Immediate Help
NEDA Helpline (US): 1-800-931-2237
Postpartum Support International Helpline: 1-800-944-4773 (Text: 503-894-9453)
