There are few times in life more emotional, transformational, and—frankly—challenging than pregnancy. Not only is the experience associated with huge life changes, but for those who have struggled with an eating disorder, pregnancy can also be uniquely triggering. While the data varies, the estimated prevalence of diagnosed eating disorders in pregnant women is between 5.1 and 7.5%, but the number of expectant mothers struggling with disordered eating and body image issues is likely higher. In fact, disordered eating among pregnant people is common enough that it’s coined at least one new term: pregorexia.

First used in 2008, the term “pregorexia” is not a clinical diagnosis, but a media-created word used to describe pregnant women who reduce their food intake or exercise excessively in order to control pregnancy-related weight gain. While the condition isn’t an official clinical disorder, the phenomenon is very real, and it can have devastating consequences for both the expectant mother and her baby. Read on to learn more about pregorexia, including the warning signs, risks, and treatment options.

What is pregorexia?

Pregorexia occurs in the peripartum period, meaning the time immediately before, during, and after giving birth. The term refers to a pregnant person’s attempts to counteract the body weight and shape changes that occur during pregnancy by reducing calories, increasing physical activity, or both.

“‘Pregorexia’ is a term that was coined to describe disordered eating behaviors and body image concerns that specifically occur during pregnancy,” says Equip Director of Program Development Tana Luo. “More specifically, pregorexia may be characterized by behaviors like restriction of intake and excessive exercise in order to avoid the weight gain and changes to the body that accompany pregnancy.”

Pregorexia is not formally recognized by the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or by the 11th edition of the International Classification of Diseases, but it is a serious issue and could be considered a clinical eating disorder, depending on the specific symptoms. “While it is not a recognized eating disorder in its own right, those who struggle with pregorexia may meet diagnostic criteria for an established eating disorder,” Luo says. “Furthermore, the risks and dangers associated with pregorexia are very real.”

What are the risks of pregorexia?

All types of eating disorders and disordered eating in pregnancy can have significant negative effects on both the pregnant person and their child, and pregorexia is no exception, whether the symptoms exhibited qualify it to be an “official” clinical disorder or not. “The behaviors associated with pregorexia may put pregnant people at risk for unstable vital signs, electrolyte disturbances, and dehydration,” Luo says. “Those who struggle with pregorexia may experience concerning symptoms, including dizziness, fainting, and fatigue.”

Aside from the physical risks associated with pregorexia, Luo says the condition can also seriously affect the mother’s psychological well-being, increasing the risk of anxiety and depression, social isolation, guilt, and shame. Research shows that there is a significantly frequent co-occurrence of anxiety and mood disorders in pregnant women with eating disorders. Eating disorders in pregnant women have also been associated with an increased risk of postpartum depression, in addition to hypertension, anemia, and other complications.

Of course, pregorexia doesn’t just affect the expectant mother—it can have serious negative effects on the unborn baby as well. Risks to the child associated with pregorexia can include everything from low birth weight and preterm labor to seizures, feeding problems, and future attention deficit disorders. “Lack of adequate nutritional intake may significantly impact the growth and development of the baby,” Luo says. “Risks include intrauterine growth restriction and low birth weight, preterm birth, and miscarriage.”

How to identify pregorexia

Like any eating disorder or form of disordered eating, pregorexia can manifest in a variety of ways, depending on the person affected and their unique circumstances. According to Luo, pregorexia is characterized by behavioral, cognitive, and emotional signs.

Behavioral signs of pregorexia

• Limiting food intake
• Skipping meals
• Being overly restrictive or rigid in food choices
• Counting calories
• Purging
• Excessive or compensatory exercise
• Weighing oneself excessively

Cognitive signs of pregorexia

• Obsessive thoughts about weight, body image, or size
• Obsessive thoughts about food

Emotional signs of pregorexia

• Extreme fear or anxiety about weight and body image
• Experiencing guilt or shame related to weight gain

In terms of physical signs, Luo says that lack of adequate weight gain during pregnancy can also be a red flag, particularly if it occurs alongside other behavioral, cognitive, or emotional symptoms.

What does treatment for pregorexia look like?

While there is no specific, one-size-fits-all form of treatment for pregorexia, anyone struggling with disordered eating during pregnancy (or any time) should seek help from a multidisciplinary team of experts offering evidence-based care. There is limited research on treatment strategies specifically for pregorexia, but the same treatment approaches that work for eating disorders outside of pregnancy are likely to be effective. The American Psychiatric Association recommends the use of cognitive behavioral therapy (CBT) and enhanced cognitive behavioral therapy (CBT-E) for pregorexia, which is the leading evidence-based approach for adults with eating disorders.

“Given that pregorexia describes disordered eating that specifically occurs during pregnancy, established eating disorder treatments would be recommended,” Luo says. “Ideally, treatment would include a focus on the behavioral and psychological aspects of pregorexia, as well as ensuring adequate nutritional intake.” For the latter, people with pregorexia should work with an anti-diet, eating disorder-informed dietitian as well as a medical provider who can ensure that they’re eating enough—and enough variety—to support themselves and their growing baby.

What to do if you or a loved one is struggling with pregorexia

All forms of disordered eating tend to be shrouded in shame and secrecy. This can be even more pronounced in the case of pregorexia, as women who are struggling may feel guilt and shame about engaging in disordered behaviors that have the potential to harm their pregnancy. But in order to address pregorexia, it’s important for people dealing with these symptoms to speak up as soon as possible to seek support.

“An important first step is to recognize the signs and symptoms of disordered eating during pregnancy and to acknowledge that these struggles are both normal and nothing to be ashamed of,” Luo says. “Society unfortunately puts a lot of pressure and attention on how people look both during pregnancy and postpartum. Validating the experience and reducing guilt and shame are crucial to then taking the next step of getting support.”

If you’re dealing with pregorexia, or are worried about a loved one, don’t wait to reach out for support. Getting prompt, evidence-based treatment is crucial to the health of both the pregnant person and their baby. Talk with your doctor or a mental health provider, or schedule a call with an Equip team member.