Pregnancy can feel particularly overwhelming for women struggling with body image and eating disorders. After all, pregnancy is characterized by weight gain and physical changes. Some women may even doubt that they can deliver a healthy baby while struggling with these diseases.

If you are actively struggling with (or have a history of) an eating disorder and find yourself pregnant, I want to offer you hope and encouragement. Your odds of having a healthy pregnancy and baby are great, despite your food-related challenges!

In this article, I want to break down some common concerns, myths, and questions about pregnancy and eating disorders.

Can I get pregnant if I have an eating disorder?

The short answer is yes.

Severe calorie restrictions can cause irregular periods and even the complete stopping of your cycles. Women with anorexia often have a harder time getting pregnant due to these irregular cycles.

However, even if you haven’t had a period in months, ovulation can occur prior to the return of menstruation. This means you can get pregnant before your next period arrives. If you frequently skip periods, you might find out you are pregnant later in your pregnancy, having assumed your missed periods are due to your eating disorder.

Does pregnancy worsen eating disorders?

You may wonder if an unexpected pregnancy and the physical changes it brings will cause your food-focused anxiety to worsen. You may be worried about a relapse despite the hard-earned progress you have made toward healthier living.

These are legitimate concerns that can (and should) be addressed with professional help, but generally, research on how women with eating disorders fare during pregnancy is encouraging.

A large recent study reported that women’s eating disorders typically improved throughout pregnancy. In another study, researchers Raymond Lemberg and Jeanne Phillips wrote that pregnancy has a “pronounced beneficial impact” on anorexic and bulimic symptoms for the duration of pregnancy.

However, the study also found that bulimic and anorexic pregnant women had higher rates of pregnancy-related weight anxiety than those without a history of anorexia or bulimia.

What effect does having an eating disorder have on a developing fetus?

One common pregnancy concern for women with anorexia or other eating disorders is low birth weight due to poor nutrition during prenatal development.

So far, research regarding increased risks to infants born to women with eating disorders is inconclusive. However, most studies that examine a wide range of women with eating disorders show few increased risks overall.

One study found that infants born to women with a history of an eating disorder largely “had normal birth weights and deliveries with an absence of congenital defects.”

Increased risk of miscarriage, low birth weight, and small for gestational age children was seen mostly in women struggling with severe anorexia or bulimia who had a history of hospitalization related to an eating disorder. However, thanks to modern medicine, these risks are growing smaller and smaller and the vast majority of low birth weight infants have normal outcomes.

How do eating disorders affect breastfeeding and postpartum health?

Eating disorders can also have ramifications for your postpartum recovery, including an increased risk of postpartum depression.

Just because you have an increased risk of postpartum depression does not mean you will experience it. However, it is a good idea to build a support team that can help you after the baby arrives. It’s also important to talk to your healthcare provider about your mood at each visit and consider medication and/or therapy if suggested.

Eating disorders can also complicate breastfeeding. Milk supply can decrease with low caloric intake, making breastfeeding difficult. If breastfeeding is a goal, make sure to talk to your provider and/or a lactation consultant to assist you in reaching this goal.

Steps for navigating pregnancy with an eating disorder

Mindset:

First, don’t panic. Most research shows that women who find themselves unexpectedly pregnant and struggle with/have a history of an eating disorder do just fine in pregnancy and go on to have healthy babies.

You may have considered reaching out for help prior to your positive pregnancy test, and this could be the perfect time to do just that. Regardless of your pregnancy decision, you deserve to have a healthy relationship with food and your body.

Talk to Your OBGYN:

It is extremely important to be honest with your healthcare provider regarding your struggles, past or present, with an eating disorder. Make sure to find an OBGYN you feel comfortable sharing this with and who takes your concerns seriously. Your doctor is an important advocate for your health during this process.

Find Accountability:

Most healthcare providers will recommend that you seek out therapy to discuss your anxieties and keep you accountable. Pregnancy, and the inevitable physical changes that accompany it, can trigger compulsive eating behaviors that were previously managed.

If you choose to parent, the stress of preparing to take on that new (or expanding) role can bring up childhood trauma and worsen anxiety.

Calorie restricting and/or binging and purging can feel like a source of control in an out-of-control situation, so finding new coping mechanisms during this time is going to be critical.

Finding a support system, especially one that includes professional help, can turn this experience into one of healing and growth.

Bonus Step! Nutritionist:

If you are able, it can be beneficial to find a nutritionist with experience in eating disorders to consult with during your pregnancy. They can help you plan out your meals and create a plan for healthy eating that extends beyond the nine months of pregnancy.

Self Advocate:

It is important that your provider weighs you regularly during your pregnancy at your prenatal visits. If this is a source of stress, ask if you can step on the scale backward and request that they do not tell you your weight.

Take a breath

If you are struggling with an eating disorder or have a history of anxiety regarding your body image, be gentle with yourself during this time of unexpected pregnancy.

Even if you have made great progress in managing your eating disorder, the unexpected changes in pregnancy can trigger relapses. Open up to your health care provider and seek out professional and personal support.