Eating Disorders in Pregnancy May Increase Maternal and Neonatal Risk
A new large U.S. study looked at what happens when pregnancy is complicated by an eating disorder. Eating disorders are often underdiscussed in prenatal care, especially when someone appears medically stable or is not actively disclosing symptoms. But this study suggests that even within a large hospital-based population, eating disorders during pregnancy were linked with higher rates of complications for both the pregnant patient and the baby.
For therapists, OB providers, fertility clinics, and patients themselves, this study is a reminder that eating disorders can affect medical outcomes during pregnancy.
What the Study Found
Researchers reviewed more than 4.3 million U.S. delivery admissions from 2016 to 2021 and identified 1,262 cases involving a documented eating disorder diagnosis. The analysis included pregnancies with any diagnosed eating disorder, including anorexia nervosa, bulimia nervosa, binge-eating disorder, and other specified or unspecified eating disorders. They found that pregnant patients with an eating disorder had higher odds of:
Anemia
Preterm labor
Disseminated intravascular coagulation
Postpartum hemorrhage
Uterine rupture
Genitourinary tract infection
Longer hospital stays
Congenital anomalies
Intrauterine growth restriction
Fetal distress
Preterm birth
The study also found that tobacco, cannabis, and alcohol use were more common in the eating disorder group, along with much higher rates of anxiety, depression, and bipolar disorder.
Why This Matters Clinically
One of the biggest problems with eating disorders in pregnancy is that they can be easy to miss. Some people minimize symptoms. Some do not meet the stereotype of what an eating disorder is supposed to look like. Some are functioning at a very high level while still struggling with restrictive eating, bingeing, purging, obsessive food thoughts, or intense distress around body changes.
This study reinforces that eating disorders in pregnancy deserve real attention, not just casual screening. The risk is not only emotional. It is obstetric too.
What the Study Does Not Mean
This study does not mean every pregnant person with a history of an eating disorder will have complications. It also does not tell us how symptom severity, treatment, recovery status, or timing of illness changed risk because those details were not available in the dataset. The authors also note that eating disorders are likely underdiagnosed in this kind of administrative hospital data.
So the takeaway is not panic. The takeaway is that earlier identification and more integrated care likely matter.
How This Often Shows Up in Therapy
In practice, eating disorder symptoms during pregnancy do not always show up as a clear disclosure. Sometimes it looks more like:
panic about weight gain that feels out of proportion
rigid food rules framed as “healthy”
deep shame after eating
obsessive checking, tracking, or body comparison
fear of losing control during fertility treatment or pregnancy
distress after provider comments about weight
avoidance of postpartum nourishment and rest
This is one reason therapy can be so important during pregnancy and postpartum. The work is not just symptom management. It is helping someone feel safer in their changing body, more honest about what is happening, and more supported before things escalate.
Bottom Line
Pregnancy can intensify eating disorder symptoms, and this study adds to the evidence that those symptoms can matter medically, not just emotionally. Pregnant patients with eating disorders may need closer monitoring, earlier support, and care that takes both mental health and maternal-fetal health seriously.
Curious to learn more? You can explore blog reflections on pregnancy and eating disorders or dive into more pregnancy research insights .
