Disordered eating during pregnancy and after birth
- Feb 27
- 6 min read
Pregnancy and the postnatal period (often referred to collectively as the “perinatal” period) can be some of the most exposed, scrutinised years of a woman’s life. Your shape changes in public. Your appetite is commented on. Your choices are monitored. And at the same time, you’re expected to “eat well,” gain the “right” amount of weight, manage symptoms, recover quickly, and finally “get your body back”.
In this environment, it’s not surprising that disordered eating can show up for many women: sometimes as a return of a past eating disorder, sometimes as new behaviours that creep in quietly under the banner of “health,” and sometimes as a way of coping with anxiety, loss of control, or trauma.
At Hesta, our aim is always to support, not judge. So we’ve worked with two of Hesta’s fantastic clinical advisors to write this post: Rebecca Moore, one of the UK’s leading perinatal psychiatrists and Tazmin Lewis, a UK registered dietitian. If you recognise yourself in any of this, the goal is simple: to help you name what’s happening, understand why the perinatal period is a risk point, and know what early support could look like for you.
First: what do we mean by “disordered eating”?
“Disordered eating” is a broad term. It includes eating behaviours and thoughts that impact physical health, mental wellbeing, or daily functioning, but may not meet full diagnostic criteria for an eating disorder.
That might include:
rigid food rules (e.g., “clean eating” that feels compulsory)
frequent guilt, shame, or anxiety around eating
skipping meals or “making up for” eating
binge eating (feeling out of control around food)
compensatory behaviours (vomiting, laxatives/diuretics, excessive exercise)
severe fear of weight gain or distress about body changes
Eating disorders like anorexia nervosa, bulimia nervosa, or binge eating disorder are diagnosable psychiatric conditions. But disordered eating can sit on a spectrum, and you don’t need a diagnosis to benefit from support.
How common is disordered eating?
It’s hard to give one tidy number, because prevalence depends on:
whether studies measure diagnosed eating disorders vs. “subthreshold” symptoms,
the tools used (questionnaires vs. clinical interviews),
timing (early pregnancy, late pregnancy, 6 months postpartum, etc.),
and differences across countries and healthcare systems.
That said, we do have some useful, validated data points*:
A 2023 systematic review and meta-analysis pooling 11 studies (over 2.3 million pregnancies) estimated the prevalence of diagnosed eating disorders in pregnancy at 4.3%, with a wide range across studies (0.5% to 10.6%).
That same paper also reported specific disordered behaviours during pregnancy in the included literature: excessive exercise (0.7%), fasting (0.3%), laxative/diuretic use (0.1%), and self-induced vomiting (0.6%). These are figures that likely undercount, because many women don’t disclose and many studies don’t capture all behaviours.
A UK-focused qualitative paper on barriers to identification notes that eating disorders in pregnancy may affect around 5.1–7.5% of women when subthreshold disorders are included, highlighting how prevalence rises when we look beyond formal diagnoses.
In England, an Office for Health Improvement & Disparities (OHID) estimate of perinatal mental health conditions (based on routine data sources) groups “other conditions including severe mental illness, eating disorders and personality disorder” at ~1.2%. This number is useful for service planning, but it does not capture subthreshold disordered eating, nor where disordered eating is coupled with a different type of mental health condition.
Postnatally, research often uses screening tools rather than diagnostic interviews, so figures can reflect “risk” rather than confirmed disorder. For example, one postpartum study using validated questionnaires reported substantial proportions of women with eating- and nutrition-related concerns (including orthorexic tendencies), underscoring that clinically relevant symptoms exist in the postpartum population but the exact prevalence of diagnosable eating disorders varies by method and setting.
The honest summary: disordered eating is not rare in the perinatal period, and “official” numbers often miss women who are suffering but don’t fit a category, or don’t disclose.
Why pregnancy and postpartum can trigger disordered eating
The perinatal period is a perfect storm of physiological change and psychological pressure. Some common drivers include:
Loss of bodily control (real or perceived)
Pregnancy changes hunger cues, digestion, shape, and appetite. For some women, controlling food becomes a way to regain a sense of control, especially if other parts of life feel unpredictable.
Identity shifts and visibility
Your body becomes a topic: in appointments, in family conversations, online. “Healthy pregnancy” messaging can slide into surveillance, where normal eating becomes something to justify.
3. Medical triggers
Some women and birthing parents require close dietary attention during pregnancy during pregnancy, either due to pre-pregnancy factors like obesity, or because of pregnancy complications (e.g., gestational diabetes). For some, structured eating plans can be helpful and protective. For others, they can unintentionally intensify rigidity, fear, or compulsive tracking. If you have a history of eating difficulties, or feel shamed or judged about your body and/or weight, this is a particularly important area for trauma-informed care.
4. Postnatal “bounce back” culture
After birth, the body is still healing, yet many women are exposed to rapid weight-loss messaging, pressure to return to exercise, and social media “transformation” narratives. This can reinforce restriction and shame right when support and nourishment matter most.
5. A history of eating disorders
Many women with past eating disorders improve during pregnancy, but symptoms can persist or relapse postpartum. Reviews emphasise that pregnancy and the postpartum period can involve changing symptom patterns (improvement for some, worsening for others) making screening and follow-up essential.
What disordered eating can look like in pregnancy vs. postpartum
Disordered eating doesn’t always look like eating very little. In pregnancy and after birth, it can present in ways that are easy to miss, or to disguise as “wellness”.
In pregnancy, it might look like:
anxiety about weight gain that dominates your day
skipping meals “to balance things out”
obsessive “perfect eating” that feels compulsory
fear-based restriction of whole food groups
purging or laxative/diuretic use (needs urgent support)
compulsive exercise despite fatigue, pain, or medical advice
Avoiding looking at your body in the mirror
After birth, it might look like:
feeling pressured to lose weight quickly
eating less to “earn” your body back
intense guilt when you eat while others “recover faster”
using feeding (breastfeeding/pumping) as a justification to restrict
binge eating in response to exhaustion, hunger, loneliness, or stress
rigid “clean” eating that escalates into obsession (sometimes described as orthorexic patterns).
A key clinical point: sleep deprivation amplifies everything, including appetite hormones, stress response, impulse control, emotional regulation. In the postpartum period, disrupted sleep can make disordered patterns more intense and harder to interrupt.
Obesity can also amplify pressure or feel traumatic during pregnancy and post birth - it is often something people feel hugely shamed and judged about during their perinatal period.
Why it matters medically (without scare tactics)
Disordered eating in the perinatal period can affect:
nutritional status (iron, iodine, calcium, vitamin D, B12)
mental health (anxiety, depression, obsessive thoughts)
energy, recovery, and immune function
relationship with feeding and body image
and in more severe cases, maternal and infant health outcomes
But this isn’t about frightening you into “eating perfectly.” It’s about recognising that your body and brain deserve support early, before patterns harden.
When to seek support
You deserve support if:
food thoughts are taking up significant mental space
you feel scared to eat, or guilty after eating most days
you’re using purging, laxatives/diuretics, or compulsive exercise
you’re binge eating and feeling out of control
your eating is affecting mood, relationships, or day-to-day functioning
you have a past eating disorder and notice old thoughts returning
If you’re pregnant or postpartum and worried, it is appropriate to tell your GP, midwife, or health visitor. NICE guidance recognises eating disorders as part of perinatal mental health care considerations, and stresses adapting treatment decisions in pregnancy and the postnatal year.
What good support looks like (trauma-informed, not weight-fixated)
A clinically sound, compassionate response will usually include:
screening and assessment that doesn’t rely only on weight/BMI
a focus on behaviours, thoughts, distress, and medical risk
support for regular eating patterns and reducing rigid rules
psychological support (often CBT-based approaches, but tailored)
collaboration with a perinatal-informed dietitian where helpful
and a plan that fits your real life (sleep, feeding, finances, culture)
It should also be trauma-informed: many women and birthing parents will not disclose disordered eating unless they feel safe, believed, and not judged. Barriers to disclosure and identification are well documented, including stigma and lack of opportunity to talk openly in maternity care.
A note for partners, friends, and clinicians
If someone you love is pregnant or postpartum and showing signs of disordered eating, the most useful first move is not to say “you need to eat”. You might want to consider a more gentle approach, such as:
“I’ve noticed you seem anxious around food. How are you doing?”
“Do you want help finding someone to talk to?”
“You don’t have to do this alone.”
And remember that support can be both emotional and practical: childcare cover for appointments, help with meals without commentary, and fewer body/weight conversations in the home.
Support and resources in the UK
If you want to talk to someone now, these are reputable starting points:
Beat (eating disorders charity) – Helplines and information: https://www.beateatingdisorders.org.uk/get-information-and-support/get-help-for-myself/i-need-support-now/helplines/
NHS – Advice on supporting someone with an eating disorder (also links to help): https://www.nhs.uk/mental-health/advice-for-life-situations-and-events/how-to-help-someone-with-eating-disorder/
Mind – Eating problems: treatment and support https://www.mind.org.uk/information-support/types-of-mental-health-problems/eating-problems/treatment-and-support/
If you’re in immediate danger or at risk of harming yourself, seek urgent help via NHS 111, your local urgent mental health line, A&E, or 999.
Disordered eating during pregnancy and after birth isn’t a niche issue, and it isn’t a personal failing. It’s a health issue that deserves the same calm, competent, compassionate care as anything else in the perinatal period.
Written by Hesta Health, and validated by Dr Rebecca Moore (UK perinatal psychiatrist) and Tazmin Lewis (UK registered dietitian).
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