Eating disorders in pregnancy

If you are pregnant and have an eating disorder (or have had one in the past), it’s important to tell your midwife and GP so that they can offer you appropriate support.

Woman looking thoughtful.

What is an eating disorder?

An eating disorder is when you have an unhealthy relationship with food, weight or body image. This can take over your life and make you ill. Friends and family may be concerned about your wellbeing. The most common types of eating disorders are:

  • anorexia
  • bulimia
  • binge eating disorder (BED)
  • other specified feeding or eating disorder (OFSED). This is diagnosed when your symptoms don’t exactly match the other types of eating disorder.

Many people may not realise they have an eating disorder. The symptoms can include:

  • spending a lot of time worrying about your weight and body shape
  • avoiding socialising when food is involved
  • not eating a lot
  • deliberately making yourself sick
  • exercising too much
  • having very strict habits or routines around food
  • changes in your mood.

It can be very hard to realise you may need help. But it is important because you can get better with support. Talk to your GP. You can take a partner, family member or friend with you if it helps.

Some women find their symptoms improve while they are pregnant but come back or get worse after they've had the baby. It’s important that all your healthcare providers know about your condition so you can get the support you need before, during and after your pregnancy.

What are the risks?

Having an eating disorder can increase the risk of:

If you have an eating disorder you may also be at higher risk of getting postnatal depression.

What should I do?

Tell your midwife or doctor about your eating disorder, and your health visitor when you meet them.

As well as talking about any physical health issues or concerns, it’s also important to tell your midwife or doctor if you are taking any medication for any mental health problems as soon as you know you are pregnant. Some types of medication for mental health problems have risks for your baby if you take them when you are pregnant or when you are breastfeeding. Your doctor should give you all the information you need to decide what to do about your medication while you’re pregnant.

To help you, your doctor will talk to you about:

  • the advantages and disadvantages of taking medication
  • the advantages and disadvantages of a different treatment option, such as guided self-help or talking therapies
  • what could happen if you stop treatment.

Do not stop taking medication for mental health problems before talking to your doctor. This can lead to withdrawal symptoms. It could also make your symptoms come back or get worse.

Ideally you should have a named professional (usually your GP or midwife) to support you during your pregnancy and after you give birth who will:

  • prepare you for the changes that will happen to your body
  • regularly check how you are getting on
  • offer you extra check-ups and closer monitoring during your pregnancy
  • talk to you about getting the right nutrition to support the  health of you and your baby.

They may also offer to refer you to a nutritionist, dietitian or a specialist in in eating disorders.

If this doesn’t happen or if you feel isolated or unsupported, talk to your midwife and GP. They can arrange more help for you.

What's the treatment?

Your healthcare professional should give you more advice on managing your symptoms, weight change and healthy eating in pregnancy. Eating Disorders and Pregnancy has more information specifically for pregnant women with eating disorders.

If you need treatment during your pregnancy you should be offered the same therapies as other people with eating disorders.

This may include guided self-help (where you carry out exercises from a book with support from a therapist) or talking therapies, such as cognitive behavioural therapy.  This may help you manage any issues about food, weight gain, body image and becoming a new mother.

After your baby is born

You’ll probably need continuing support after your baby is born. You may find the eating disorder gets worse again, even if your symptoms were better during pregnancy. Because you may also be more likely to develop postnatal depression, you and your partner may find it helpful to find out more about postnatal depression so you can recognise the signs and symptoms, just in case.

Your doctor should arrange for you to be seen in the first few weeks after your baby is born. Talk to your midwife or doctor about what your care will be after your baby is born.

Have a support network in place

You can’t plan for everything, especially when it comes to being a new parent. But you may find it helpful to talk to family and friends about your condition and what they can do to help you stay well after the baby is born. This may help you feel more prepared and in control.

Make sure your closest family and friends understand your condition and how it affects you. For example, you could talk to them about:

  • the symptoms you have experienced in the past
  • what medication you take (if any)
  • any warning signs they should look out for
  • who they can contact if they are worried about you.

Friends and family can also provide practical support, such as:

  • cooking healthy meals for you
  • taking the baby for a walk so you can get some sleep
  • doing any household chores for you, such as cleaning or laundry
  • spending time entertaining the baby while you take a break – even if it’s just to have a bath or shower.

This may help reduce any extra stress and let you concentrate on staying well.

More information and support

B-EAT 

MIND 

www.eatingdisordersandpregnancy.co.uk has more information on managing eating disorder symptoms, weight change and healthy eating in pregnancy.

Read more here about having a healthy diet in pregnancy

Read more

Sources

NHS Choices Eating disorders https://www.nhs.uk/conditions/eating-disorders/ (Page last reviewed: 16/01/2018. Next review due: 16/01/2021)

Easter A et al (2015) Antenatal and postnatal psychopathology among women with current and past eating disorders: longitudinal patterns. European Eating Disorders Review. 2015 Jan; 23(1): 19–27.Published online 2014 Oct 26. doi: 10.1002/erv2328  

Clinical Knowledge Summaries (Aug 2017) Pre-conception advice and management https://cks.nice.org.uk/pre-conception-advice-and-management

Sue Macdonald and Julia Magill-Cuerden Mayes’ Midwifery (Edinburgh: Baillir̈e Tindall Elsevier, 2012), p 198

NICE (2013) Antenatal and postnatal mental health: clinical management and service guidance National Institute for Health and Care Excellence

NICE (2017). Eating disorders: recognition and treatment NICE clinical guideline 69. National Institute for health and care excellence https://www.nice.org.uk/guidance/ng69/ifp/chapter/Eating-disorders-the-care-you-should-expect

Knoph C et al (2013) Course and predictors of maternal eating disorders in the postpartum period. International Journal of Eating Disoders 2013 May;46(4):355-68. doi: 10.1002/eat.22088. Epub 2013 Jan 11.

Kimmel MC et al (2016) Obstetric and gynecologic problems associated with eating disorders. International Journal of Eating Disorders 2016 Mar;49(3):260-75. doi: 10.1002/eat.22483. Epub 2015 Dec 29.

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Last reviewed on October 18th, 2018. Next review date October 18th, 2021.

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