Eating Disorders Disrupt Healthy Sexual Function

Dysfunction was especially higher in those with lower lifetime BMIs.

Eating disorders can interfere with many aspects of normal life, including sexual function, according to a recent study of 242 women participating in the International Price Foundation Genetic studies (Int J Eat Disord; 2010; 43:123).

When Andrea Poyastro Pinheiro, MD and a group of eating disorders experts assessed physical intimacy, libido, sexual anxiety, partner status, and sexual relationships among the women, they found that nearly half (44.7%) reported either avoidance of or absence of sexual relationships. Women with restricting and binge-purge type anorexia nervosa (AN) had the highest percentage of loss of libido—75% and 74%, respectively, compared to 39.1% for those with bulimia nervosa (BN) and 45.4% for those with eating disorder not otherwise specified (EDNOS).

For comparison purposes only, data were taken from a group of 202 women without eating disorders who were not part of Dr. Pinheiro’s study. Compared to the women with no history of eating disorders, more of the women with eating disorders had loss of libido, prevalence of sexual anxiety, tension, frequently changed partners, and reported detached relationships. More women with eating disorders also reported avoiding sexual relationships but fewer reported not having a partner. Nearly two-thirds of women with eating disorders reported loss of libido and elevated levels of sexual anxiety. And, compared to the women without eating disorders, more women with eating disorders reported loss of libido, elevated sexual anxiety, relationships without sex and relationships with tension.

Low BMI and more severe symptoms

The authors reported that one consistently observed finding was the association between low lifetime body mass index (BMI, or kg/m2) and loss of libido and presence of sexual anxiety and problems with sexual relationships. These findings are consistent with the explanation that low body weight impairs the physiological functioning of sexual organs and also echoes evidence from other studies showing that fluctuations in BMI are directly related to changes in sexual interest (Psychol Med 1981; 11:131; Lancet 1979; 1:612). Another explanation might be that, independent of physical changes, individuals with lower BMIs have more severe eating disorders and the increased illness may be associated with more profound body dissatisfaction, body distortion, depression, and discomfort with physical contact, all of which can lead to loss of libido and elevated levels of sexual anxiety.

The authors concluded that sexual intimacy is a fundamental aspect of healthy relationships that can be disrupted by an eating disorder, and thus it should be routinely assessed along with other more commonly evaluated areas of function. According to the researchers, little is now known about how recovery from an eating disorder may affect sexual functioning. However, future studies on the impact of eating disorders upon intimate relationships may help clinicians develop approaches to treatment that will help persons with eating disorders improve intimacy and interpersonal connections.