Researchers followed 30 women with eating disorders (like anorexia and bulimia) through pregnancy and four years after giving birth. They found that eating disorder symptoms often continue during pregnancy and after the baby is born, which can cause complications for both mom and baby. Women with bulimia had more pregnancy problems like gestational diabetes, while women with anorexia were more likely to have premature babies. The study shows that women with eating disorders need special medical care and support during pregnancy to protect their health and their baby’s development.

The Quick Take

  • What they studied: Whether eating disorder symptoms continue during pregnancy and after birth, and how these symptoms affect the health of mothers and their babies
  • Who participated: 30 women who had been diagnosed with eating disorders before pregnancy (21 had anorexia nervosa, 9 had bulimia nervosa). Researchers checked on them during pregnancy and again about four years later
  • Key finding: Most women continued to have eating disorder symptoms during and after pregnancy. Nearly half still met the criteria for an eating disorder four years later. Babies born to mothers with anorexia were more likely to be born early and have slower development, while mothers with bulimia had more pregnancy complications like gestational diabetes
  • What it means for you: If you have a history of eating disorders and are pregnant or planning to become pregnant, you should tell your doctor. Extra monitoring and support during pregnancy may help protect both your health and your baby’s health. This research suggests eating disorders don’t automatically go away during pregnancy, so professional help is important

The Research Details

This was a longitudinal study, which means researchers followed the same group of women over time rather than just looking at them once. They studied 30 women with eating disorders at two different time points: first when they were evaluated for their eating disorder symptoms, and again about four years later. At the first evaluation, researchers used detailed interviews and questionnaires to assess the severity of eating disorder symptoms. At the second evaluation (four years later), they looked back at medical records from pregnancy and after birth to see what happened. They used national health records to track information about the mother’s health during pregnancy and the baby’s health and development after birth.

The researchers specifically looked at three types of eating disorder behaviors: restricting food intake, self-induced vomiting, and misusing laxatives. They also tracked pregnancy complications and how babies developed in their first years of life, including when they reached milestones like sitting up, walking, talking, and toilet training.

This research approach is important because it follows real women through an important life event (pregnancy) and tracks actual health outcomes for both mothers and babies. Rather than just asking women to remember what happened, the researchers used official medical records, which are more accurate. This type of long-term follow-up helps us understand how eating disorders affect not just the mother, but also the developing baby and young child

This study has some strengths: it used official medical records rather than relying on memory, it followed women over a long period, and it looked at both mother and baby health. However, the sample size is relatively small (30 women), which means the findings may not apply to all women with eating disorders. The study was conducted in one country, so results might be different in other places. The researchers did not have a comparison group of women without eating disorders, which would have made it easier to see exactly how much the eating disorder affected outcomes

What the Results Show

The most important finding was that eating disorder symptoms did not disappear during pregnancy and after birth. Women continued to restrict their food intake, use laxatives, and in some cases, continue vomiting throughout pregnancy and the postpartum period (the time after the baby is born). This was true for both women with anorexia and women with bulimia.

Women with bulimia (the type involving binge eating and purging) experienced more severe symptoms overall and had higher rates of pregnancy complications. These complications included hyperemesis gravidarum (severe nausea and vomiting during pregnancy), gestational diabetes (high blood sugar during pregnancy), and preeclampsia (high blood pressure during pregnancy that can be dangerous).

Women with anorexia (the type involving severe food restriction) had a different pattern. While they had fewer pregnancy complications than women with bulimia, their babies were more likely to be born prematurely (before 37 weeks). Additionally, babies born to mothers with anorexia showed more delays in reaching developmental milestones—they were slower to sit up, walk, talk, and develop bladder and bowel control compared to babies born to mothers with bulimia.

Four years after the initial evaluation, nearly half of the women still met the diagnostic criteria for an eating disorder and were still receiving treatment. Even women whose eating disorder symptoms had improved still struggled with body dissatisfaction and negative thoughts about their appearance.

Beyond the main findings, the research revealed that cognitive features of eating disorders—the thoughts and beliefs about body image and weight—persisted even when some eating behaviors improved. This suggests that the mental health aspect of eating disorders is particularly stubborn and doesn’t automatically resolve during pregnancy. The study also highlighted that the effects of maternal eating disorders extended beyond pregnancy complications to affect children’s early development, suggesting that the impact lasts years after birth

Previous research has shown that eating disorders can affect fertility and pregnancy, but this study provides more detailed information about what happens during and after pregnancy. Earlier studies suggested that some women improve during pregnancy, but this research shows that improvement is not the typical pattern—most women continue to struggle. The finding that different types of eating disorders affect pregnancy differently (bulimia causing more pregnancy complications, anorexia causing more premature births and developmental delays) adds important new information to what we already knew

This study has several important limitations to keep in mind. First, the sample size is small—only 30 women—so the findings may not apply to all women with eating disorders. Second, there was no comparison group of women without eating disorders, making it harder to know exactly how much the eating disorder contributed to the problems observed. Third, the study was conducted in one country, so results might be different in other places with different healthcare systems. Fourth, the researchers relied on medical records for some information, which might not capture all eating disorder symptoms if women didn’t report them to their doctors. Finally, the study doesn’t tell us about women with eating disorders who didn’t become pregnant, so we don’t know if pregnancy outcomes are different for those who do become pregnant

The Bottom Line

If you have a history of eating disorders and are pregnant or planning to become pregnant, inform your healthcare provider immediately. Work with a team that includes your doctor, a mental health professional, and possibly a nutritionist who understand eating disorders. Regular monitoring during pregnancy is important to catch complications early. After the baby is born, continue mental health support and monitor your baby’s development. These recommendations are supported by this research and should be discussed with your healthcare team (moderate confidence level—based on a small study but consistent with clinical experience)

This research is most relevant for women with a history of eating disorders who are pregnant or planning pregnancy. It’s also important for their healthcare providers, including obstetricians, pediatricians, and mental health professionals. Partners and family members of women with eating disorders should also understand that pregnancy doesn’t automatically resolve eating disorders. This research is less relevant for women without eating disorder history, though it may help them understand the challenges others face

Eating disorder symptoms typically don’t improve on their own during pregnancy—they often continue or may even worsen. Benefits from treatment and support may take months to appear. Baby developmental delays may become noticeable in the first 1-2 years of life. Long-term recovery from eating disorders often takes years, as shown by the fact that nearly half of women in this study still had active eating disorders four years later

Want to Apply This Research?

  • If you have a history of eating disorders and are pregnant, track daily food intake, any restrictive eating patterns, and pregnancy symptoms (nausea, energy levels, weight changes). Also note any mental health symptoms like anxiety or body dissatisfaction. Share this information with your healthcare team at regular appointments
  • Use the app to set reminders for regular meals and snacks to support consistent nutrition during pregnancy. Set goals for attending mental health appointments and track mood and anxiety levels. Create a support network feature to connect with your healthcare team and trusted family members who can help during vulnerable moments
  • After pregnancy, use the app to track your baby’s developmental milestones (when they sit, walk, talk, etc.) and compare them to typical timelines. Monitor your own eating patterns and mental health symptoms long-term. Schedule regular check-ins with your healthcare team and use the app to prepare questions or concerns to discuss. Track any pregnancy complications that occurred and how you’re managing recovery

This research describes patterns observed in a small group of women and should not be used for self-diagnosis or self-treatment. If you have an eating disorder or suspect you might, or if you are pregnant and have concerns about eating disorders, please consult with a qualified healthcare provider, including your doctor and a mental health professional. Eating disorders during pregnancy require professional medical and psychological care. This information is educational and not a substitute for personalized medical advice. Always discuss any concerns about pregnancy, eating, or your baby’s development with your healthcare team.