Pregorexia: Signs, Symptoms, & Treatments

What Is Pregorexia?

Pregorexia is a mainstream term that has become more popular in recent years to describe the obsession and fear of weight gain during pregnancy.² Pregorexia symptoms may emerge as soon as a woman discovers she is pregnant. She may fear gaining too much weight or losing control over her body. This anxiety may lead to measures like calorie restriction, excessive exercise, binging, and purging.

In 2004, New York Magazine published a viral article, The Perfect Little Bump, that chronicled the fears of weight gain and the intense measures women took to control their bodies during pregnancy.³

Who Is at Risk for Pregorexia?

Women with previous histories of eating disorders are the most at risk of developing pregorexia. Even if the woman has recovered, the weight gain and feeling of losing control in pregnancy may cause a relapse of symptoms. With that, relationship stress, body dissatisfaction, and thin-ideal internalization are also risk factors of pregorexia.⁴

Is Pregorexia an Eating Disorder?

Although it isn’t an officially diagnosable disorder, pregorexia is considered a form of disordered eating. While eating disorders are clinical diagnoses, disordered eating habits refer to abnormal, unhealthy patterns that do not meet the full criteria for a diagnosis. Some people may struggle with disordered eating for several months or years before progressing into the development of an eating disorder.

Pregorexia Vs. Anorexia

Pregorexia symptoms are similar to anorexia symptoms. In both cases, the person fears gaining weight, restricts calories, or develops obsessive food rituals as a means of control. But, pregorexia refers to the specific fear of gaining weight while pregnant. This fear may not be as pervasive (or relevant) before or after the pregnancy. Someone with anorexia globally fears gaining weight regardless of their current circumstances.

A person with anorexia may develop pregorexia. Likewise, pregorexia symptoms may transition into anorexia after the baby is born. This can happen if the person feels pressured to “lose the baby weight” quickly. They may continue restricting food to get back to their original weight or a weight even lower than that. However, excessive postpartum weight loss can exacerbate fatigue and affect breast milk supply.

Pregorexia Symptoms

Someone who experiences pregorexia will engage in calorie restriction and other behaviors centered around eating. Some disordered signs may be apparent to others. However, like other eating disorders, people often attempt to conceal their habits due to fear, shame, or worry about judgment. They may, for example, eat “normally” in front of others only to engage in harmful behaviors when they are alone.

Symptoms of pregorexia may include:

• Excess fatigue
• Gaining too little weight or losing weight
• Dizziness and fainting
• Dehydration
• Concentration problems
• Increased body aches and pains

Outward Warning Signs of Anorexia During Pregnancy

Someone dealing with pregorexia might display signs like:

• Eating alone: Someone may choose to eat alone to avoid feeling scrutinized or questioned by other people.
• Being overly focused on their appearance rather than their baby: Someone with pregorexia may feel more preoccupied with weight gain than their developing baby.
• Exercising an excessive amount: Pregorexia sometimes coincides with excessive or compulsive exercise.
• Lack of weight gain: While women gain weight at different times and paces during pregnancy, someone with pregorexia may show an obvious lack of weight gain even through their third trimester.

What Causes Pregorexia?

There isn’t an exact cause of pregorexia. Like other eating disorders, experts believe various risk factors may increase someone’s likelihood of developing this condition.

Risk factors that can contribute to the development of pregorexia include:

• Societal pressure: Environmental triggers, such as sociocultural or familial expectations, may play a significant role. If someone experiences continuous pressure to remain thin or maintain their body shape, those pressures may persist throughout pregnancy.
• Unresolved mental health concerns: Mental health factors like low self-esteem, depression, and anxiety may contribute to disordered eating.
• Stress: Pregnancy is inherently a stressful time full of many unknown variables. It’s a massive change in a person’s life. Focusing on weight or numbers may provide an expectant parent with some semblance of control.
• Having a history with eating disorders: People with histories of eating disorders or disordered eating may find their patterns become even more exacerbated during pregnancy.
• Genetics: Genetics and eating disorders appear to be linked. People with eating disorders often have a first-degree relative with an eating disorder.

Why Weight Gain Is Important During Pregnancy

Weight gain during pregnancy helps your body grow and provides ongoing nourishment to your developing baby. Some calories and other nutrients contribute directly to the size of the baby, but other proteins, fats, vitamins, and minerals are distributed to resources like amniotic fluid, the placenta, your uterus, and extra blood.⁵ Gaining too little weight in pregnancy is associated with complications like premature birth and low birth weights.

Potential Health Risks of Anorexia During Pregnancy

There are clear health risks associated with exhibiting anorexic symptoms during pregnancy. These risks can result in serious consequences for the mother, baby, or both. In general, pregnancies in women with anorexia are considered to be high-risk. Women can benefit from close monitoring and supportive treatment efforts throughout this process.⁶

Risks for the Mother

Risks for mothers experiencing pregorexia include:⁶

• Malnutrition
• Failure to gain adequate weight
• Increased risk of Cesarean section
• Poor mental health
• Increased hyperemesis
• Maternal ketoacidosis
• Hypoglycaemia
• Anemia

Risks for the Baby

Babies born from pregorexic parents may experience:⁷

• Increased risk of miscarriage
• Respiratory distress due to premature birth
• Feeding difficulties
• The baby having lifelong physical, cognitive, or behavioral disorders
• Other perinatal complications

Pregorexia Treatment

If you are struggling with disordered eating, body image concerns, or other issues related to your weight during pregnancy, it’s important to seek help and be honest with your OBGYN about any past or current struggles. Treatment is available, and it is possible to stay healthy and have a healthy baby during this vulnerable time.

Treatment for pregorexia may include:

• Individual therapy: Individual therapy can offer support and encouragement during pregnancy. If you are struggling with pregorexia, your therapist can provide a nonjudgmental environment to help you process your feelings and manage distressing symptoms.
• Nutrition counseling: A dietitian can help ensure that you get proper nutrition for you and your growing baby. They may recommend a certain meal plan based on your specific needs.
• Additional OBGYN appointments: Your OBGYN may want to monitor your pregnancy more closely due to pregorexia. This doesn’t mean you’ve done anything wrong—they just want to ensure you and your baby are safe.
• Support groups: Many therapists, hospitals, and community mental health agencies offer support groups for people struggling with disordered eating. Having peer-based support can help you feel less alone during this time.
• Prenatal, pregnancy, and childbirth classes: Learning about what to expect during pregnancy and the early days of parenting may help you feel more prepared.
• Couples therapy: Couples therapy may be helpful for expectant parents and their partners. Maintaining open communication and having support may help people with pregorexia manage their conditions better.
• Online therapy: If you have a busy schedule, online therapy offers convenience and accessibility. Look for a therapist with experience in eating disorders and perinatal issues, or use a specific online program for eating disorders, like Equip Health.

Coping Options for Pregorexia

An expectant mother dealing with pregorexia may also benefit from:

• Meditation: Embracing mindfulness can help you manage your stress and feel more confident. A regular meditation process may reduce pregorexia urges.
• Body neutrality or body positivity cognitive exercises: It may be empowering to reframe how you view your body. Embracing body neutrality or body positivity can help you have a more realistic perspective of the changes occurring to you physically.
• Prenatal exercise: If your doctor recommends physical activity, ask about safe prenatal exercises. Consult with them to develop an appropriate plan that honors your body’s need for movement without overdoing it.
• Blind weigh-ins: Your healthcare provider needs to track your weight. But you can ask them to weigh you without looking at the number.
• Learning more about your baby’s nutritional needs: Your own body and developing baby have unique needs during pregnancy. Educating yourself on what can best support your health may bolster better coping.
• Connecting with your baby: Getting excited about your growing family may coincide with wanting to take better care of yourself to properly nourish your baby. Women can connect with their babies by singing to them, talking to them aloud, preparing their nursery, and getting other affairs in order before the birth.