Eating Disorders and Body Shame in Pregnancy and Postpartum: What Providers Need to Know

When we think about perinatal mental health, we often talk about depression and anxiety—but there’s a critical area that remains under-recognized and under-researched: eating disorders and body image distress during pregnancy and postpartum.

Emerging data shows that between 27–31% of perinatal individuals experience body dysmorphophobia (intense shame and distress related to body image) or struggle with disordered eating behaviors (Vanderkruik, 2022). Despite these numbers, many medical and mental health providers still feel unequipped to assess or address these concerns in their pregnant and postpartum patients.

It’s time for that to change.

Why Eating Disorders During the Perinatal Period Matter

Pregnancy and postpartum are intense times of transition—emotionally, hormonally, relationally, and physically. For those with a history of eating disorders or disordered eating behaviors, the rapid body changes, weight monitoring, and identity shifts of this life stage can be deeply triggering.

Even individuals with no prior diagnosis may find themselves experiencing:

• Obsessive body checking or avoidance

• Restriction, binging, or purging behaviors

• Exercise compulsion

• Guilt related to hunger, fullness, or cravings

• Intense shame around postpartum body changes

When untreated, perinatal eating disorders can lead to:

• Poor maternal-infant bonding

• Nutritional deficits affecting both parent and baby

• Increased risk of perinatal mood and anxiety disorders (PMADs)

• Complications in childbirth and recovery

For healthcare professionals—including dietitians, therapists, OB-GYNs, psychiatrists, and primary care doctors—understanding how to identify and respond to eating disorders in the perinatal population is critical to improving outcomes.

Body Image in Pregnancy and Postpartum Periods

Body dysmorphophobia, or the deep shame and distress around one's body image, is often dismissed as vanity, but it is a serious psychological concern with measurable consequences. The perinatal body becomes highly scrutinized, by society, family, medical systems, and the person themselves. When that scrutiny turns inward and becomes toxic, it can lead to disordered behaviors, depression, anxiety, and isolation.

Research is still catching up, but the 27–31% prevalence rate should serve as a wake-up call: we need more providers trained to recognize body image distress and deliver trauma-informed, weight-neutral, and affirming care to perinatal individuals (Vanderkruik, 2022).

Vanderkruik, R., Ellison, K., Kanamori, M., Freeman, M. P., Cohen, L. S., & Stice, E. (2022). Body dissatisfaction and disordered eating in the perinatal period: an underrecognized high-risk timeframe and the opportunity to intervene. Archives of women's mental health, 25(4), 739–751. https://doi.org/10.1007/s00737-022-01236-6

The Need for Integrative Maternal Mental Health Training

At The Couch Therapy, we created the Integrative Maternal Mental Health Providers Training to fill this gap. This training is designed for:

• Dietitians supporting prenatal and postpartum nutrition

• Eating disorder therapists treating individuals navigating pregnancy and recovery

• OB-GYNs, nurses, and doulas seeing patients in daily care settings

• Mental health clinicians who want to integrate trauma-informed approaches to eating and body image in the perinatal period

Led by Emily Morehead, MA, LPC-S, a TEDx speaker, perinatal mental health expert, and PhD researcher in maternal identity and reproductive grief, this training dives into:

• The intersection of eating disorders and PMADs

• Trauma-informed body image work in the perinatal season

• Culturally responsive, HAES-informed care

• Tools for screening, collaboration, and referral

You’ll also receive CEUs, a clinical resource handbook, and lifetime access to the training materials.

Let’s Raise the Standard of Perinatal Care

Eating disorders and body shame in pregnancy and postpartum are real—and far more common than we’ve been led to believe. As providers, we have a responsibility to see the signs, ask better questions, and offer informed, compassionate care.

Register now for the Integrative Maternal Mental Health Providers Training and become part of the solution.