Lately, there has been an upsurge in the prevalence of eating disorders, owing primarily to changes in sociocultural factors [1]. Body image disorders are not benign. They dictate risky behaviors that engender major physical and mental health harm as well as damage to social life [1]. Through the history of mankind, the concept of beauty has evolved to the point that thinness nowadays represents success among women. It is estimated that 11–72% of them are dissatisfied with their body [2].

Pregnancy remains a complex “biopsychosocial phenomenon” that can witness the emergence of concerns about weight, body image, femininity, and self-esteem [3]. These preoccupations are usually triggered by the emotional-hormonal ambivalence of pregnancy, resulting in the development of new eating disorders or the exacerbation of previously existing ones as a means of coping with harmful feelings such as anxiety or phobic and obsessive–compulsive traits [3]. Consequently, pregnancy may serve as a basis for the occurrence of “pregorexia”—a notion of popular psychology designating a newly emerging behavior. In 2008, the term “pregorexia” first appeared in “The Early Show and Fox” press, referring to the excessive fear of pregnancy-induced weight gain and the drive to control it through various measures (e.g., extreme restriction of calorie intake, excessive exercising, or diuretics and/or laxatives consumption) [4, 5].

This neologism results from combining “pregnancy” and “anorexia” [5]. However, to date, “pregorexia” has neither been considered a medical diagnosis nor classified in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) eating disorders criteria. Additionally, it has not been assigned any international formal or medical definition yet [6]. We might simply define it as anorexia nervosa occurring for the first time during pregnancy [5], taking into account that women with “pregorexia” may experience eating restriction as well as bingeing followed by purging [4]. In addition, some alarming signs or “red flags” for “pregorexia” have been identified, such as skipping meals, eating alone, and talking about pregnancy as if it is not real (i.e., state of denial) [4].

Surprisingly, the prevalence of eating disorders (i.e., anorexia nervosa, bulimia nervosa, binge eating disorders, Other Specified Feeding or Eating Disorder, etc.) during pregnancy varies greatly between studies, ranging from 0.6 to 27.8% [7,8,9,10,11,12,13,14,15,16,17,18]. These disparities could be explained by the diversity of assessment tools, varying from self-report questionnaires to structured interviews [8]. Additionally, the self-report measures used in research were inconsistent with one another, as some tools were based on adapted versions of pre-existing scales for eating disorders, whereas others were designed on items derived from the DSM-4/DSM-5 criteria [8]. This incongruity has therefore posed fundamental problems in the assessment of disordered eating during pregnancy, emphasizing the need for a consensual and accurate pregnancy-specific screening tool, as previously suggested by a Delphi study [19], to facilitate comparisons in research and reduce the likelihood of false negative and false positive tests.

Furthermore, a recent systematic review has refuted the suitability of traditional existing measures for detecting eating disorders in pregnancy, pointing out that only four of sixteen scales used across countries were presented with established psychometric properties [18]. Namely, the Eating Disorder Examination (EDE), a semi-structured clinical interview, and three self-report measures, the Eating Disorder Examination Questionnaire (EDE-Q) [20, 21], the Eating Disorders Inventory-2 (EDI-2) [22], and the Disordered Eating Behavior Scale (DEBS) [23], have been used among pregnant samples [18]. Nonetheless, none of these instruments was able to show a commendable degree of clinical pertinence in terms of psychometric performance, such as internal consistency, criterion-related validity, or screening accuracy. As a result, no existing scale could be set as a “gold standard” measure or substitute the necessity for a specially designed instrument to identify dysfunctional eating symptoms during pregnancy [18].

Besides, when it comes to “pregorexia”, to the best of our knowledge, the only documented prevalence worldwide is 5% [24]. Nevertheless, most healthcare professionals are unaware of this condition [6]. The scarcity of studies exploring this phenomenon proves that raising awareness is essential, especially when considering the importance of a balanced diet during pregnancy and the risks of undernutrition for both the mother and fetus (e.g., placental abruption, miscarriage, low birth weight, type 2 diabetes mellitus, cardiovascular diseases, neural tube defects, cognitive disorders, as well as maternal anemia, impaired bone mineralization, post-partum depression, etc.) [25, 26]. In fact, barriers to the identification of eating disorders during pregnancy are principally stigma and poor professional training [27]. In addition, the lack of confidential discussions about weight gain, mental health, and body dissatisfaction between pregnant women and their physicians accounts for the limited detection and management of “pregorexia” [4].

Furthermore, the literature has highlighted the associations between disordered eating during pregnancy and maternal psychological distress (i.e., anxiety, stress, and depressive symptoms) [15, 28], accentuating the threatening impact of these conditions on maternal mental health. In light of these facts, providing healthcare professionals with an efficient screening tool for the early detection of disordered eating attitudes during pregnancy is of prime importance, in order to optimize diagnostic and treatment procedures and thus circumvent negative health repercussions. However, it is only in 2018 that Bannatyne et al. generated a brief pregnancy-specific instrument in furtherance of screening for antenatal eating disorders: the Disordered Eating Attitudes in Pregnancy Scale (DEAPS), which demonstrated a high level of internal consistency (Cronbach’s alpha value of 0.85) and good validity (KMO value of 0.88; p < 0.001) [16]. The DEAPS also had a unidimensional latent structure and a strong correlation with EDE-Q, supporting its convergent validity and further strengthening its construct validity [16]. This scale’s items were built on the results of their authors’ Delphi study, which made the distinction between anodyne pregnancy-related changes in eating habits and pathological eating symptomatology during pregnancy [29]. In order to be applied among Lebanese pregnant women, its cross-cultural adaptation requires a translation process into Arabic, Lebanon’s native language. Therefore, our study's objective was to examine the reliability and psychometric properties of the Arabic version of this pregnancy-specific scale among Lebanese pregnant women.