Wednesday, 9/04/2025
PHOTO: Getty Images
TEXT: Andres Gurri
Motherhood is a time of major life changes both physically and emotionally. For many women, it can be a particularly sensitive time if they have experienced or are experiencing a complicated relationship with food or their bodies.
Eating Disorders (ED), such as anorexia nervosa, bulimia nervosa and binge eating disorder, mainly affect young women of childbearing age, which makes them especially relevant during pregnancy and postpartum. It is estimated that approximately 7% of pregnant women present an ED, although some studies suggest that this figure could be as high as 20%, given the difficulty in diagnosing them during gestation, due to the fact that some symptoms overlap with the normal dietary changes of pregnancy (changes in appetite or food preferences). With this, several studies show that the ongoing diagnosis of an ED is associated with an increased risk of physical and mental health problems for both the pregnant mother and the baby.
EDs and Pregnancy: Impact on Fertility and Gestational Complication
Prior to pregnancy, it is known that a person suffering from an eating disorder may have both menstrual and sexual difficulties. Although it can usually affect the fertility rate (especially in cases of anorexia), many of them manage to get pregnant. Because of this, some physical complications may occur during pregnancy, such as recurrent miscarriages, severe nausea and vomiting, premature delivery, preeclampsia (hypertension and organ damage), perinatal death and/or alterations in fetal weight (low birth weight or macrosomia). However, the outcome does not always have to be negative.
Moreover, as mentioned above, ED not only affects the physical level, but can also have a direct impact on the psycho-emotional health of the mother. This way, during gestation, it is common for women who suffer from it to experience more anxiety or sadness, becoming more difficult to manage. These feelings can be exacerbated in the postpartum period, and it is estimated that up to 30% of mothers with a history of ED may develop postpartum depression.
Added to this, the social demands of motherhood, along with the lack of rest and internal pressure to regain the “old body,” contribute to affecting their ability to form an emotional bond with the baby and perform the maternal role. On the other hand, they may also experience increased discomfort, due to concern about the bodily changes associated with pregnancy.
Effects of Pregnancy with Anorexia on the Newborn and Breastfeeding
Taking into account the possible gestational complications, it is relevant to know that, sometimes, newborns born to mothers with ED may present an increased risk of health problems, such as:
- Low birth weight
- Reduced cranial circumference
- Prematurity
- Microcephaly (small head)
- Delayed intrauterine growth
- Anemia
- Low Apgar scores (indicator of newborn’s health status)
For those mothers who have experienced an ED, this can trigger difficult emotions such as anxiety, sadness, feelings of disconnection, dissatisfaction with the body or guilt. Consequently, all of these can affect breastfeeding. These psychological factors have been found to significantly influence early breastfeeding cessation: although most manage to initiate breastfeeding, they may find it more difficult to maintain exclusive breastfeeding. Again, this early cessation may affect mother-infant bonding as well as infant nutrition.
Psychosocial and Emotional Impact on the Mother with an Eating Disorder During Pregnancy
Eating Disorders not only affect the body physically but also impact the mother’s psycho-emotional health. During pregnancy, it is common for women with eating disorders to experience emotional disturbances such as anxiety and depression.
According to studies, these issues can worsen during the postpartum period, with estimates suggesting that up to 30% of mothers with a history of eating disorders develop postpartum depression. The emotional and social demands of motherhood, combined with the pressure to “get their pre-pregnancy body back,” contribute to this increase.
It is well known that postpartum depression can affect a mother’s ability and willingness to bond emotionally with her baby and to fulfill the maternal role. Additionally, mothers who have suffered from or are currently experiencing an eating disorder may also face a significant increase in anxiety, which can exacerbate the symptoms of their disorder due to concerns about the bodily changes associated with pregnancy.
Eating Disorders During Pregnancy: A Risk Cycle for Offspring
Children of mothers with eating disorders may have a higher risk of developing eating and body image problems, especially girls. According to recent studies, girls are up to three times more likely to engage in purging behaviors, as mothers’ concerns about weight and body image are transmitted to them, increasing the risk of adopting problematic eating attitudes.
In summary, eating disorders have a profound impact on maternal-fetal health and the mother-child bond. During pregnancy, women with eating disorders face a higher risk of both physical and emotional complications. Consequently, their babies are more likely to experience health problems, with breastfeeding often being affected first. Additionally, children—particularly girls—are at risk of developing their own eating disorder. Therefore, early detection, a multidisciplinary approach to prenatal and postnatal care, and continuous support are essential to reduce risks for both mother and baby.
References:
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Chamorro, M., & Hospital Sant Joan de Déu. (2022). Projecte SOM. Riscos per a la mare i el nadó. Els trastorns de la conducta. https://tca.som360.org/ca/monografico/dona-salut-mental/blog/trastorns-conducta-alimentaria-lembaras
Çiçekoğlu Öztürk, P., & Taştekin Ouyaba, A. (2023). Prevalence and related factors of eating disorders in pregnancy: A systematic review and meta-analysis. Archives of Gynecology and Obstetrics. https://recoveredtobe.com/embarazo-postparto-trastornos-alimentarios/
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Sánchez, C., et al. (2024). Trastornos de la conducta alimentaria y evolución durante el embarazo y posparto. Revista Sanitaria de Investigación. https://revistasanitariadeinvestigacion.com/trastornos-de-la-conducta-alimentaria-y-evolucion-durante-el-embarazo-y-posparto/