Whether pregnancy was on your bingo card for this year (or for the last several years) or not, first trimester nausea can tarnish the energy of even the most wanted pregnancy. One day you’re staring at two pink lines on your pregnancy test, googling baby names, and downing green juice (for the folate!). The next, you can barely get out of bed, let alone stomach opening your fridge and face all the *smells*. Trying to figure out what to eat in the first trimester can feel like a part time job.

First trimester nausea, food aversions, exhaustion, and appetite shifts are so normal. If you never had to deal with them, how does it feel to be God’s favorite? Just kidding. But really, first trimester “morning sickness” can be a real drag. Not to mention, a huge trigger for anyone with a history of an eating disorder or food-related anxiety. 

As hard as it is, it can also give you the chance to loosen your grip on any rigidity you’ve been holding on to with food. Perfection is not possible, but it’s especially out of reach when your hormones are in the driver’s seat and suddenly foods that were once safe start to make you gag. 

In this post, we’ll talk about why these appetite changes happen, and what to eat in the first trimester when you have zero appetite – especially if you have a history of an eating disorder.

Why Appetite Disappears in the First Trimester

Unfortunately, the first several weeks of pregnancy are often accompanied by nausea, sudden food aversions, heightened smell sensitivity, and, for some people, vomiting. 

So why does your body feel like it’s been hit by a truck shortly after you realize you’re pregnant? Well, hormones, particularly hCG (human chorionic gonadotropin) seem to be mostly to blame. Here’s what your body is doing and how those changes might be affecting you:

  • hCG: Peaks around weeks 8-10 and overlaps with the peak of placental development. Some researchers believe the nausea and vomiting of early pregnancy is a byproduct of rapid placental growth – the body mounting an intense hormonal and immune response as it builds an entirely new organ.
  • Progesterone: Continues to rise in early pregnancy and can slow gastric emptying, meaning that food sits in your stomach longer than usual. While this allows your body to potentially absorb more nutrients, it can also contribute to feelings of queasiness, fullness, and bloating. 
  • Estrogen: Linked to heightened smell sensitivity, which is why a smell that never bothered you before can now send you running from the room.

Along with hormones, blood sugar fluctuations can play a role too. The body works harder to regulate blood glucose in early pregnancy, and blood sugar can dip more quickly than pre-pregnancy. This helps to explain why an empty stomach can often make nausea worse, and why eating consistently throughout the day, even every hour or so, can help keep symptoms at bay. 

Another theory for nausea and food aversions is the “maternal defense hypothesis”, which proposes that these symptoms evolved as a protective mechanism to steer people away from certain foods during the window of the first trimester where the placenta is not yet fully developed or filtering potential toxins. Once the placenta is up and running (typically by the end of the first trimester), symptoms often ease. 

In 2024, researcher Marlena Fejzo published a breakthrough study regarding a potential cause of hyperemesis gravidarum – severe nausea and vomiting in pregnancy. Her study identified a hormone called GDF15, which is primarily produced by the developing placenta, as a major driver of HG. People who have lower levels of GDF15 before pregnancy appear to be more sensitive when levels spike in early pregnancy. Researchers are now exploring potential treatments including “priming” people at higher risk with metformin to increase GDF15 levels before pregnancy. 

Overall, there’s still no solid consensus as to why nausea hits some people harder than others. The same person can have wildly different experiences between pregnancies – the body’s sensitivity to these hormonal shifts can change each time.

I want to make sure to point out that nausea and vomiting can be particularly challenging for anyone with a history of disordered eating, so you’re not alone if you’re finding yourself struggling mentally as well. 

I also know that not experiencing first trimester appetite changes or nausea can be its own source of anxiety, as you may fear the symptoms mean anything about the strength or health of the pregnancy. Whether or how severely you experience symptoms seems to have more to do with your own body’s makeup than anything about the pregnancy itself. So you just may be lucky!

Tip 1: Scale Back the “Balanced Meal” Standard (For Now)

For most pregnant people, the first trimester is about survival. Thinking about how to compose a balanced meal might send you into a nausea spiral. There may only be one or two foods that even seem remotely appealing. Perhaps a weird flavor combination sounds like the best thing ever. 

Here’s what I recommend when considering what to eat in the first trimester: follow your instincts. Eat what sounds good and appealing. There’s probably a reason you’re craving it, and eating enough is more important right now than eating perfectly. 

Of course, if you can tolerate it, there’s benefit to trying to get a balance of protein, fat and carbohydrates with your meals and snacks for improved blood sugar regulation, which can help manage nausea itself.

Make sure you’re taking a quality prenatal (more on that below), staying hydrated to the best of your ability, and focusing on eating what you can manage. Rest assured, no matter what your intake looks like right now, the body will prioritize using nutrients for fetal development. This will most likely be a temporary phase in your pregnancy.

Tip 2: Focus on What You Can Tolerate, Not What You “Should” Eat

When it comes to what foods to eat in the first trimester, prioritize what you can tolerate. Here are some of my most common recommendations:

  • Cold or Room Temperature Foods. These tend to be tolerated better than hot since they don’t emit strong aromas. Think: chicken salad sandwich vs. chicken stir fry. 
  • Bland Carbs as an Anchor. Crackers, toast, rice, pasta. These are often the most well-tolerated foods and that’s perfectly fine – your body needs carbs right now and there’s no reason to limit them. To the best of your ability, try to pair with a protein, fat or fiber source: cheese, yogurt, nut butter, hummus, avocado, eggs. 
  • Get Creative with Protein. Protein-boosted pastas (Brami, Goodles, Banza) can make a comforting bowl of pasta actually pull some more nutritional weight – most offer around 20g of protein per serving. Stirring Fairlife milk into cereal or a smoothie is an easy way to add protein without changing the flavor much. 
  • Fruit! Often fruit is much more well-tolerated than vegetables in the first trimester (though not always!) Fruit is a great way to incorporate micronutrients, fiber, and added hydration into your diet when veggies aren’t happening. 
  • Salty Snacks. These tend to be easier on a queasy stomach and can help with electrolyte balance if you’ve been vomiting. 
  • Smoothies or other liquid nutrition. This can be easier to consume when chewing feels like too much. Blend up some fruit with yogurt, chia seeds and even frozen riced cauliflower for a nutrient-dense smoothie that doesn’t taste like a salad.  
  • Electrolytes. Finding an electrolyte powder you enjoy can not only make it easier to stay hydrated, but can help your body maintain its electrolyte balance through any nausea or vomiting. If you’re not able to tolerate much of anything or are experiencing frequent vomiting episodes, choose an electrolyte powder or sports drink that contains carbs and sugar – your body needs them! I generally don’t recommend sugar-free versions of electrolyte powders since the carbohydrates support fluid absorption and energy when you’re not keeping much down. But if all you’re able to eat is carbs and simple sugary foods, you may find a non-sugary option more appealing. A few I recommend: Skratch, Liquid IV, Ultima (a lower-sugar option).

Tip 3: Rethink Meal Timing – Eat Before You’re Hungry

Most people find that an empty stomach leads to worse nausea in the first trimester. Getting ahead of hunger before it *really* hits can help you stay ahead of symptoms, even though it might not feel the most intuitive at first. If you’re not used to eating every three or so hours, this can be tough. Set reminders on your phone or block out time in your calendar for meals and snacks. Keep ready to eat bars, trail mix, or whatever you’re tolerating best within easy reach. 

For morning nausea, keeping something simple like saltine crackers or rice cakes on your nightstand and eating them before getting out of bed can help swerve symptoms right away.

Whether you find that grazing throughout the day or eating structured meals and snacks works better for your schedule, the goal is steady intake and avoiding going long periods of time without eating anything. 

Tip 4: Lean on Your Prenatal Vitamin

Prenatal vitamins are supposed to supplement your food intake and act as a safety net in case your diet happens to be low in particular nutrients that are important during pregnancy. Nutrient needs for various micronutrients *do* increase during pregnancy, and it can be easy to stress that you’re failing your developing baby by not eating perfectly. When your diet is limited to bagels, lucky charms, and potato chips, you might be freaking out. 

Here’s the thing: your body is surprisingly good at prioritizing the baby even when your diet is chaotic – though we don’t want to run that experiment for too long and leave you depleted postpartum. That said, a prenatal helps fill genuine gaps so you’re not relying on your diet alone to do all the work. 

A prenatal is a standard recommendation during pregnancy, and if you’re dealing with food aversions it’s particularly important. There are so many different prenatal options out there: with or without iron, with or without DHA, with or without choline, etc. In general, I recommend prenatals that are formulated for optimal absorption (look for methylated B vitamins) and that don’t contain iron (so you can supplement separately as needed). 

Think also about when you’re taking your prenatal. You might find it makes you more queasy on an empty stomach, so pair with food when possible. If your prenatal has a multiple-capsule serving, split it up throughout the day. If you struggle with keeping pills down, a chewable or gummy prenatal might be the best fit for you.

A note if you have a history of disordered eating

If you have a history of an eating disorder or currently struggle with a complicated relationship with food and your body, the first several weeks of pregnancy can be particularly challenging. Thinking about what to eat during the first trimester might feel like a minefield.

Perhaps pregnancy nutrition guidance is stirring up old anxieties around eating “right” and “wrong.” Nausea can feel like an excuse to restrict, or like eating less would help you cope better – it won’t. Vomiting due to morning sickness when you have a history of purging can be incredibly destabilizing or make it hard to know what behaviors are pregnancy-related or rooted in the eating disorder.

This is a GREAT time to work with a prenatal dietitian who is familiar with treating eating disorders if you don’t already. Need one? Reach out to me!

Remember: This phase is temporary

Most people don’t have to endure intense food aversions, nausea, or vomiting for the entirety of their pregnancy. Typically, most people turn a corner around the second trimester and find their diets are able to return to what they’re familiar with pre-pregnancy (perhaps with some additional pregnancy-specific food cravings). 

Your job right now is just to keep going, keep eating, and keep doing your best. Your body and your baby don’t need perfection – good enough is great.