Pregnancy and Bulimia: Concerns for the Fetus

Pregnant woman concerned about ED Recovery and Motherhood

Eating disorders are emotionally, medically, and psychologically complex and become even more so with pregnancy and bulimia. Bulimia Nervosa poses risks for fetal development even before conception, increasing the risk of infertility as well as the possibility of “miscarriages, fetal growth problems, perinatal mortality, low or high birth weight, premature birth, and birth defects [1].”

Pregnancy and Bulimia Influences

Impact of Stress

Mamas-to-Be that are struggling with bulimia nervosa are often experiencing increased distress and anxiety related to their disordered eating behaviors and pregnant status. Studies have long-shown that prenatal stress impacts fetal behavior, neurodevelopment, and the stress response [2].

The chemicals impacted in the stress response, such as cortisol, create prenatal stress, which is known to affect birth weight, adult cardiovascular outcomes, as well as psychological functioning. Maternal stress during pregnancy also impacts cognitive development and fearfulness during early childhood [2].


Under-nutrition in early life undoubtedly impacts the fetus, negatively effecting its metabolic programming throughout life. Further, under-nutrition “increases fetal exposure to maternal cortisol, therefore suggesting a possible effect of maternal under-nutrition not only on nutritional programming but also on fetal stress responses [2].”

Additionally, “fetal exposure to higher cortisol levels is also associated with lower birth-weight [2].”

Glucose Levels

Image of a baby's foot after Pregnancy and BulimiaEngaging in bingeing and purging behaviors impacts the mother, and therefore, the baby’s glucose levels. Bingeing on foods that have a high glycemic index rapidly increases blood sugar. Purging then “disrupts the complex interplay between gut hormones and digestion, leading to rapid falls in blood sugar [2].”

These rapid changes in blood sugar can be damaging to a developing fetus.

Impact After Birth

One study found that babies whose mothers engaged in bulimic behaviors during pregnancy showed “different feeding styles and greater infant feeding problems [1].” Additionally, maternal beliefs and practices related to food, exercise, and body image have proven to be a significant contributor to a child’s beliefs and behaviors in these same areas.

It is crucial to acknowledge that all mothers want what is best for their babies. No mother would choose to engage in any activity that would directly harm their little one.

Eating disorders are cunning and manipulative diseases. They are similar to addictions and can overtake an individual even when they try their hardest to fight it.

Please remember that this information is provided for informational purposes and is presented without judgment. If you are a Mama-To-Be and continue to struggle with bulimia, you are not alone. You are supported by this community.


[1] Watson, H. J. (2014). Psychosocial factors associated with bulimia nervosa during pregnancy: an internal validation study. International Journal of Eating Disorders, 48.

[2] Micali, N., Treasure, J. (2009). Biological effects of maternal ED on pregnancy and fetal development: a review. European Eating Disorders Review, 17.

About the Author:

Image of Margot Rittenhouse.Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.

The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published March 26, 2020, on
Reviewed & Approved on March 26, 2020, by Jacquelyn Ekern MS, LPC