Sexual Function and Attitudes Among Women with Eating Disorders

Women with eating disorders have more conservative attitudes toward sex and poorer than normal sexual functioning, according to the results of a recent study reported at the 2004 International Conference on Eating Disorders. Women with anorexia nervosa and/or who were single were more likely to have poorer sexual functioning. These conclusions were based on the results of a widely used questionnaire, according to the authors.

Leslie J. Heinberg, PhD, of Case Western Reserve University School of Medicine, Cleveland, and colleagues examined sexual attitudes and functioning among 34 women inpatients with Structured Clinical Interview for DSM-IV Axis I Disorders (SCID)-confirmed eating disorders. During the first week of hospitalization, the women anonymously answered the attitudes subscale and self-report version of the Derogatis Inventory of Sexual Functioning, along with general questions about their relationships and sexual orientation. The median age of the group was 26.6 years, and 84% were Caucasian. Twenty-six percent of the women had anorexia nervosa, restricting subtype; 19% had anorexia nervosa, purging subtype; 26% had bulimia nervosa, and 29% had eating disorders not otherwise specified.

Lower sexual function was seen on several scales

In this population, sexual functioning was two standard deviations below female norms, as were sexual cognition, sexual arousal, sexual behavior, and sexual drive. Orgasmic functioning was also two standard deviations below female norms.

When the patients were categorized by type of eating disorder (anorexics vs. bulimics), bulimics had higher scores on sexual arousal and sexual behavior than did the patients with anorexia nervosa. No differences were reported between restricting and purging anorexic patients. Single women had significantly more conservative attitudes toward sex than women who were married or living with a partner.

Similar pattern seen in younger patients

Results from an earlier study in Finland involving a group of adolescents 14 to 21 years of age, who had either anorexia nervosa or bulimia nervosa, showed that general attitudes toward sexuality were more negative among anorexic patients than among bulimic patients. The anorexic patients also had fewer experiences with dating and less interest in dating than did those in the bulimic group (Eur Child Adolesc Psychiatry 2003; 12:214). Dr. J. Rouska and co-workers at the University of Tampere, Tampere, Finland, used semi-structured interviews and self-report questionnaires to assess the 57 young patients.

Some of these results, of course, may be related to the effects of being hospitalized and also to the fact that most of the women were experiencing the effects of starvation.