Perinatal Eating Disorders: How the Perinatal Period Can Lead to Food and Body Image Concerns

Thrive • August 18, 2022
By Thrive Wellness National Director of Risk Management Kerstin Trachok, CPC

The perinatal period which accounts for pregnancy through one year postpartum, involves many changes to a person’s body and lifestyle. For some, these changes can be distressing and contribute to perinatal eating disorders, which can be detrimental to both the mother and baby. Integrating perinatal mental health care with eating disorder treatment can help expecting and new mothers adjust, accept, and appreciate their evolving bodies. 

HOW THE PERINATAL PERIOD CAN TRIGGER EATING DISORDERS

Throughout pregnancy, a person’s body undergoes substantial changes. An expecting mother gains necessary, healthy weight as a baby grows inside her. Her breasts and feet often become larger, and she may experience bloating and constipation . For someone who already has body image concerns, these changes can exacerbate existing negative body image struggles and prompt disordered eating thoughts or habits.

Some mothers without previous body image issues may also feel triggered by the changes during the perinatal period. However, for these individuals, the postpartum period tends to be the most challenging. After giving birth, many mothers are faced with a very different body than the one they had pre-pregnancy, an experience that can also lead to negative body image and disordered eating.

EATING DISORDERS DURING PREGNANCY

Diagnosing an eating disorder during pregnancy can be difficult. Pregnant mothers may struggle with all types of eating disorders including anorexia, bulimia, and binge eating disorder (BED) . A person who exhibits symptoms of an eating disorder while they’re pregnant often won’t have a body mass index (BMI) that matches the diagnostic criteria for the eating disorder outlined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). For example, a person may be severely underweight during their pregnancy without technically qualifying for a true anorexia diagnosis. 

SIGNS AND SYMPTOMS OF PERINATAL EATING DISORDERS

Some behaviors that are evident of perinatal eating disorders include:

  • Excessive exercise
  • Restricting food intake
  • Obsessive calorie counting
  • Self-induced vomiting 
  • Laxative use
  • Feeling shame or guilt about weight gain 
  • Frequently weighing oneself or measuring the size of one’s body
  • Fear or intense distress about gaining weight
  • Not attending doctor appointments to hide their condition from their physician 
  • Isolating oneself from family and friends due to feeling uncomfortable in one’s body

A perinatal eating disorder may also contribute to difficulty bonding with one’s baby, such as:  

  • Feeling disconnected from one’s baby during pregnancy
  • Blaming one’s baby for the changes in one’s body
  • Experiencing attachment issues with one’s baby postpartum
  • Feeling shame or guilt about one’s struggle to bond with their baby 

THE DANGERS OF PERINATAL EATING DISORDERS

Perinatal eating disorders can have harmful consequences for both the mother and baby, including:

  • Bone loss for the pregnant person
  • Growth restrictions for the baby 
  • Fetal developmental problems
  • Low birth weight due to lack of nutrients
  • Fatigue beyond what would be considered normal for a pregnancy
  • Electrolyte imbalances and abnormalities
  • Dehydration
  • Dizziness
  • Prolonged labor
  • Miscarriage 

A PREEMPTIVE APPROACH TO PERINATAL EATING DISORDERS

If a person planning to have a child has struggled with an eating disorder or negative body image, they could benefit from proactively seeking therapeutic support to protect themself and their baby from the dangers of eating disorders. 

An eating disorder therapist can help:

  • Address any food, body, or eating behavior concerns 
  • Develop a plan for if the eating disorder is retriggered during the perinatal period
  • Manage eating disorder thoughts and behaviors that might arise 
  • Educate and involve a person’s loved ones so they can help monitor the person and support them throughout the perinatal period
  • Help guide a person in facilitating conversations with their primary care providers about their eating disorder concerns
  • Connect a person with primary care providers that are knowledgeable about eating disorders

COLLABORATIVE PERINATAL AND EATING DISORDER TREATMENT AT THRIVE WELLNESS

Thrive Wellness’ perinatal mental health and eating disorder treatment programs offer comprehensive care to guide expecting and postpartum mothers in developing and nurturing healthy relationships with food and their bodies. A person struggling with a perinatal eating disorder can attend a hybrid of both programs while having access to a collaborative interdisciplinary treatment team with experience treating both perinatal mental health and eating disorders. Reach out to learn more about our various services. 

While all Thrive Wellness locations offer interdisciplinary clinical teams who collaborate to treat eating disorders, perinatal mood and anxiety disorders (PMADs), and additional mental and behavioral health conditions, programs and services may vary by location.

About the Author

Thrive Wellness National Director of Risk Management Kerstin Trachok, CPC

Kerstin received her master’s degrees in clinical mental health counseling and school counseling from the University of Nevada, Reno. She has several years of experience in the counseling field working in different settings and treating a wide array of mental health issues. Her experience includes working in schools with children of all ages, clients with psychosis in a hospital setting, and adults and teens in private practice as well as working at an agency providing counseling to children and families and two years of experience working with eating disorders at the partial hospitalization program (PHP) and intensive outpatient program (IOP) levels of care.

Kerstin is a fully licensed clinical professional counselor in the state of Nevada and received her certification in Complex Trauma Levels I and II. She has experience working with children, teens, adults, and families with trauma, anxiety, grief, depression, attention-deficit/hyperactivity disorder (ADHD), autism spectrum, suicidal ideation, eating disorders, obsessive-compulsive disorder (OCD), and behavioral issues. Kerstin is passionate about fostering clients’ growth and autonomy while providing a safe and secure space to process emotions. She uses creative interventions and other tools to allow clients to voice their internal experiences beyond traditional talk therapy and her modality of choice is acceptance and commitment therapy (ACT). She uses mindfulness tools and techniques to help clients be present-moment oriented and reduce stress so they may move towards psychological flexibility. Kerstin believes all individuals have the right to live a full and vital life.

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November 11, 2025
Are you looking for a meaningful way to give back this holiday season? Thrive Wellness is excited to continue our 6th Annual Giving Tree Program in collaboration with Perenn Bakery this winter. This year, Thrive Wellness Reno and Perenn Bakery are proud to partner with Ronald McDonald House Charities® of Northern Nevada. The organization supports families with children receiving treatment at area hospitals, providing comfort, hope, and a home-away-from-home during challenging times. Ronald McDonald House Charities offers essential services, removes barriers, strengthens families, and promotes healing when children need healthcare the most. How It Works Simply take one (or a few) tags from the Giving Tree, each listing an item you can purchase and donate for residents of the Ronald McDonald House. Then, drop off your item(s) at one of our designated donation locations by Friday, December 19. Items Needed: Restaurant gift cards Walmart or Target gift cards Games, puzzles, and coloring books Toys (Barbie, Hot Wheels, Lego sets, craft sets, magnet blocks, baby dolls, action figures, journals, infant toys, etc.) Children's books (picture, chapter, and graphic novels) Toiletry sets (for adults) Lotion/self-care gift sets (for adults) Sweatshirts/hoodies (adults, XS-XXL) Scarves, gloves, fuzzy socks, pajamas (all sizes) Infant diapers, onesies, and baby bottles Bulk individually wrapped snacks (granola bars, chips, etc.) Please ensure all donations are new, in original packaging, and unwrapped. Donation Drop-Off Locations Please deliver donations by Friday, December 19, to one of the following sites: Thrive Wellness 491 Court St., Reno, NV 89501 201 W Liberty St., Suite 201, Reno, NV 89501 Perenn Grocery 7600 Rancharrah Pkwy, Suite 130, Reno, NV 89511 Perenn Rancharrah 7750 Rancharrah Pkwy, Suite 110, Reno, NV 89511 Perenn Midtown 20 St. Lawrence Ave, Reno, NV 89509 Claio Rotisserie 3886 Mayberry Dr., Suite D, Reno, NV 89519 Why We Give Back Through our Giving Tree program, we’re honoring one of our core values at Thrive Wellness: staying rooted in community. This annual tradition allows us to give back to those who need support most during the holiday season. We invite you to join us by taking a tag at any Thrive or Perenn location and helping spread kindness throughout our community. There’s no better way to embrace the holiday spirit than by supporting local families with thoughtful, heartfelt donations. We are deeply grateful for your generosity and continued support. Thank you for helping us make a difference!
September 22, 2025
Eating disorders are one of the most serious mental health concerns facing today’s adolescents. They can affect every aspect of a young person’s life, including their physical health, school performance, relationships, self-esteem, and more. According to the National Institute of Mental Health, about 2.7% of adolescents in the U.S. will experience an eating disorder in their lifetime, and many more engage in disordered eating behaviors that may not meet full diagnostic criteria. The good news is that providers are in an influential position to notice early warning signs, open conversations, and connect families to support before these patterns of behavior become too engrained. Why Early Intervention Matters The earlier an eating disorder is identified and treated, the better the treatment outcomes. Research shows that getting support quickly after the disorder’s onset is linked to faster recovery, lower relapse rates, and healthier long-term development (Treasure & Russell, 2011). Waiting too long to seek help can mean medical complications, deeply ingrained behaviors, and a more difficult path to healing. For many adolescents, a caring provider who notices the signs and advocates for treatment can make all the difference in recovery and can even save lives. Recognizing Early Warning Signs Adolescents may not always disclose their struggles directly, so providers should keep an eye out for a range of indicators: Physical signs: noticeable weight changes, menstrual irregularities, digestive issues, dizziness, or fatigue. Behavioral patterns: skipping meals, restrictive eating, excessive exercise, frequent dieting, eating in secret, or leaving for the bathroom after meals. Emotional and cognitive signs: preoccupation with weight or body shape, food rituals, heightened anxiety around eating, or perfectionistic tendencies. It’s important to remember that eating disorders don’t always “look” a certain way. Teens can be distressed about food and body image even if their weight appears to be within a “normal” range. Screening Tools and Assessments Using free screening tools available online can be an effective way to gauge a patient’s needs and gain further insight on treatment options for a possible eating disorder. Here are 4 free screening resources we recommend you use before making a referral for a higher level of care. EDE-Q (Eating Disorder Examination Questionnaire) : helps assess eating attitudes and behaviors. Nine Item Avoidant/Restrictive Food Intake disorder screen (NIAS) : helps to assess the signs of ARFID in children. Eat 26 Screening Tool : a screening measure to help you determine attitudes towards food and eating. BEDS-7 (Binge Eating Disorder Screener) : for situations where binge eating is suspected. When possible, gathering input from parents, teachers, or coaches can also help, as teens may minimize their experiences out of fear or shame. The Role of Primary Care and Pediatric Providers Routine checkups are often where eating disorders first come to light. Providers treating children, teen, and adolescents can: Incorporate simple questions about eating habits and body image into wellness visits. Track growth charts and weight trends while pairing them with questions about mood, anxiety, and behavior. Foster trust by creating a safe, nonjudgmental space where adolescents feel comfortable sharing sensitive information and know there will be no weight stigma. Coordinating Multidisciplinary Care Supporting a young person with an eating disorder works best when care is collaborative . In order to treat the whole person, there are usually multiple members of a treatment team needed, including: Medical support: monitoring vital signs, lab work, and physical health. Therapeutic care: evidence-based approaches such as family-based therapy (FBT) and cognitive-behavioral therapy (CBT) help address thoughts and behaviors. Nutritional guidance: dietitians provide education, meal support, and reassurance. Family involvement: engaging caregivers empowers them to support recovery in everyday life. Addressing Barriers and Stigma Many families face challenges in seeking help, whether due to stigma, lack of awareness, or limited access to specialists. To help, providers can: Normalize conversations about body image and mental health as part of overall well-being. Use culturally sensitive approaches that honor diverse experiences with food, body, and health. Connect families to community organizations, online resources, or telehealth when in-person specialty care is limited. Eating disorders in adolescents are serious, but with early recognition and timely support, recovery is possible. Providers are often the first to notice changes and can play a vital role in opening doors to crucial support. By blending professional expertise with empathy and collaboration, providers can guide adolescents and their families toward lasting recovery and a healthier future. References National Institute of Mental Health. (2023). Eating Disorders . Treasure, J., & Russell, G. (2011). The case for early intervention in anorexia nervosa: theoretical exploration of maintaining factors. The British journal of psychiatry : the journal of mental science, 199(1) , 5–7.
By Julia Actis, LCSW September 11, 2025
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