Women’s health behaviors during pregnancy have long-lasting effects for both mother and child. One common consequence of health-compromising behaviors is excess gestational weight gain (GWG), or gaining more weight than recommended by the Institute of Medicine. Various risk factors for excess GWG span the biopsychosocial spectrum, but one factor that is typically absent from the discussion is binge eating (BE). This study attempted to better understand the experiences of pregnant women who binge eat and explore the connection between BE and excess GWG as well as assess the role of health care providers in the experiences and behaviors of pregnant women. Two hundred and thirty-five women who were pregnant in their third trimester completed an online survey assessing symptoms of BE, body dissatisfaction, dietary restraint, psychological distress, and weight gain. Twenty of those women completed a telephone interview to describe their pregnancy journey and interactions with health care providers. Consistent with hypotheses, quantitative results highlighted that past body dissatisfaction was significantly correlated with current body dissatisfaction (r = 0.52, p < .01) and that current body dissatisfaction was significantly related to BE frequency independently (β = .02, p < .01) and mediated through dietary restraint (indirect effect = .01) and psychological distress (indirect effect = .02). However, based on logistic regression analyses, BE was not a significantly associated with GWG status in the third trimester of pregnancy as hypothesized, but body dissatisfaction was (β = .03, p < .01; Exp(B) = 1.03). Qualitative results provided examples of relationships among variables and helped provide additional potential pathways between body dissatisfaction and GWG. Women provided descriptions of how their interactions with health care providers may have exacerbated symptoms of body dissatisfaction and psychological distress and how the amount of information they were provided negatively impacted their trajectory of symptoms and outcomes. Results from this study suggest that health care providers should be screening for body dissatisfaction during pregnancy and supporting women by providing referrals for appropriate support. Additional recommendations based on participant feedback are provided.