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Eating Disorders and Sex


min read


Eating disorders cause a host of issues that affect every area of your life. However, one area which receives little attention is that of sexuality. Yet for many sufferers, sex is a major problem for those who suffer from all kinds of eating disorders, from anorexia to binge eating disorder.

Low sex drive, lack of self-confidence and a fear of intimacy can impact severely on sufferers’ sex lives. Here, we take a look at why this is the case and what can be done about it.

Eating Disorders Affect Intimacy Of All Kinds

Over the years, researchers have looked into the ways in which eating disorders can impact on families. However, much of that research focused on the parent/child relationship rather than that between romantic partners.

Spouses and partners of those with eating disorders often report that they feel as if they take second place to their loved one’s problem and that they are physically and emotionally distant from them.

In the West, intimacy is usually seen as an indicator that couples are in a healthy relationship. However, with someone who has an eating disorder, it’s often viewed as a frightening closeness which puts barriers in between the sufferer and their partner.

Eating disorders affect both body and mind. These disorders take over the way in which the sufferer views themselves and the world around them, creating a false sense of self. This impacts on intimacy at all levels. While most people assume that intimacy refers only to the physical act of sex, in fact, it also refers to other types of intimacy too.

There are four types of intimacy which are involved in any significant relationship:

  • Intellectual intimacy involves a couple discussing and exchanging their ideas and thoughts on different topics.
  • Experiential intimacy involves the couple participating in activities together such as playing sports, attending concerts or going out with friends.
  • Emotional intimacy involves each individual identifying and sharing their feelings about a conversation, situation or event. This is an essential step in connecting and feeling close with a partner and in knowing they accept and understand the way you feel.
  • Sexual intimacy refers, of course, to either non-penetrative sexual actions or intercourse itself. It may also include such simple acts of affection as cuddling and holding hands.

Eating disorders can affect all four types of intimacy in your relationship.

Food And Sex – An Obvious Pairing

For generations, food and sex have been inextricably linked. Perhaps this is because both are basic human needs, essential to function physiologically. We only need to look at the way that sexuality is used to promote food products through advertising – we’ve all seen chocolate adverts featuring sultry women – to see just how deep this connection is.

However, for people with eating disorders, there is a very strained relationship with both food and sex. Sexuality is very closely linked with the individual’s self-esteem, body satisfaction, and physicality. Eating disorders distort all of these things.

When someone with an eating disorder begins to use food to control, over-indulge or deny their primal instincts, it stands to reason that the relationship they have with that other major human need, sex, suffers too.

How Do Eating Disorders Impact On Sexuality?

When someone has an eating disorder, sexual dysfunction is a very common side effect. In cases where the sufferer has a very low body weight, lost libido and low testosterone production are common. There may also be physiological impairs to the sex organs’ function.

The physiological complications associated with eating disorders, however, are only the tip of the iceberg. The core features that lie at the heart of an eating disorder including distorted body images, body dissatisfaction and shame all inhibit a healthy sexual function too.

People suffering from eating disorders will naturally display a negative attitude towards sex. They will have more sexual anxiety and reduced sexual satisfaction. This is true amongst both male and female sufferers.

Interestingly, people with different types of eating disorders may display different negative patterns of sexual behavior. People with anorexia often have a restrictive approach to sex while bulimia sufferers are more likely to try to win approval through satisfying their partner’s needs.

People who have constricted emotions usually exhibit more restrictive sexuality while those who have emotional dysregulation usually exhibit self-destructive and impulsive sexual behavior. In short, it appears that there is some mirroring between the way eating disorder sufferers engage in sex and in their behavior around food.

In virtually all cases, however, those with eating disorders report that their illness affects their sexual relationships, preventing intimate connections and compromising their romantic partnerships.

So, why do eating disorders have such an impact on sexual function? Here, we take a closer look at some of the elements which may be involved.

Malnutrition Can Affect The Way The Brain Functions

People who suffer from anorexia often suffer from malnutrition. When the brain is malnourished it stops functioning properly. If you cannot eat sufficient calories to keep your energy levels regulated, your body will begin to shut down vital systems to help conserve that energy. Starvation causes hypogonadism. This stops the ovaries from functioning properly.

Reduced levels of progesterone and estrogen, the hormones produced by the ovaries which relate to sexual function, impact on sex drive. This is a common side effect of the menopause, but it’s also common in anorexia sufferers too.

Depression Causes Sexual Dysfunction

A decreased sex drive doesn’t necessarily stem from having an eating disorder. It may instead arise due to the depression that accompanies the eating disorder. Depression is known to negatively impact on sexual function.

Around 33%-50% of eating disorder sufferers have a mood disorder. This may explain why so many of them have a low sex drive. Some of the treatments used for depression such as SSRIs also negatively impact on sexual function by reducing sexual desire and causing difficulties in reaching orgasm.

Abuse Causes Trauma

Some sufferers of eating disorders have developed their problem due to abuse in their life. Around half of all anorexia sufferers report having experienced abuse at some point, whether physical, emotional or sexual. That abuse also impacts significantly on sexuality.

Negative Self-Image Makes It Difficult To Have Sex

People suffering from any type of eating disorder have a negative self-image. This makes it difficult to have sex. In many cases, having a sex aversion isn’t about physiological barriers, it’s about psychological ones. If you’re uncomfortable with the way you look, engaging in sexual content is embarrassing and challenging.

People who are dissatisfied with their body, regardless of whether they suffer from eating disorders or not, report that they have sex less frequently and orgasm less often. People with a negative body image usually report that they are uncomfortable with initiating any kind of sexual activity, with undressing in front of a partner, with exploring any new sexual activity or to have sex with the light on.

Personality Traits Also Have An Impact

Many sufferers of eating disorders believe their illness is causing their sexual dysfunction. However, in some cases, it’s actually just a natural facet of their own personality. Some of the personality traits which are commonly seen in eating disorder patients are also connected with being disinterested in sex. Having a preoccupation with behaviors and thoughts (or obsessionality), perfectionism and restraint are three key personality traits which are frequently associated with certain eating disorders.

These personality traits also impede sexual interest and enjoyment. Sex can make sufferers feel out of control. It may feel too indulgent or messy. All of this leads to sex being an uninviting concept. Also, we all have a different sex drive. While some people naturally have a high sex drive, others naturally have a low one. This is normal, however, in today’s hypersexual culture we often come to believe that having a low sex drive is somehow wrong.

Is It A Problem To Be Disinterested In Sex?

Sufferers of eating disorders often wonder whether it’s really a problem that they have a low sex drive. This is an interesting question. Essentially, if having a low sex drive isn’t causing you a problem in your life then it shouldn’t be viewed as a major issue to be addressed at this stage. The only thing that counts is the way that you feel about it.

On the other hand, however, if you’re feeling distressed about having a sexual dysfunction you should certainly take steps to find out more about it and get a solution so you can improve your quality of life.

Couple Therapy | Eating Disorders | Meadowglade

Getting Treatment For Sexual Dysfunction With An Eating Disorder

Although many people with eating disorders suffer sexual dysfunctions and complications, it’s quite rare to find sexuality being discussed during eating disorder treatments. It isn’t too surprising, then, that many eating disorder sufferers continue to have negative feelings about sex even after they have finished their treatment.

Some sufferers find that when they cease their eating disorder behavior and restore their bodyweight to a normal level their libido naturally increases. However, shame, a negative attitude towards sex and body dissatisfaction can all result in ongoing complications in relationships and sexual function even after the sufferer is in recovery.

Sexuality has close links to body image and self-esteem. Both of these issues often linger on long after the behavioral and physical manifestations of an eating disorder have gone. Therefore, it’s vital to discuss the link between sexuality and eating disorders as part of the treatment process. A key component of any treatment for eating disorders is finding the authentic and true identity of the individual outside their eating disorder.

While sexuality is an inherent, basic aspect of our humanity, and is a key element of any intimate relationship it is, unfortunately, also a difficult topic to raise in today’s culture. This makes it hard to discover and explore yourself as a sexual person and to come to a better understanding of the way you function sexually.

To get past the barriers that those with eating disorders put up against intimacy, it’s advised that patients change the way they think. Instead of focusing on the form of their body, they focus on its function, speaking out loud positive affirmations. Affirmations have a role to play in reprogramming the way the brain works.

At first, you just have to say the positive statements aloud – it isn’t necessary to believe them. However after repetition, eventually the brain becomes rewired to believe the things you say. Some patients suffering from eating disorders need to improve their social skills while maintaining effective boundaries, even in situations which aren’t of a sexual nature.

The best way to restore positive sexual relationships is to practice feeling more safe in relationships without a sexual context. Feeling comfortable around other people can be a challenge, but it’s possible if you take your time. Asking a work colleague to go out for a stroll at lunchtime or to have a coffee together is a good way to begin sharing personal spaces. You can then work up from there to something more intimate.

Essentially, having sex requires you to be intimate and this is the primary issue. When a patient with an eating disorder wants to get back to being intimate in this way, it sometimes helps for their partner to see their therapist too. This will help them to learn how best to support their loved one without rushing them or putting them under undue pressure. A therapist can advise couples how best to return to intimacy in a comfortable way that suits both parties.

Addressing Sexual Issues In Eating Disorders

Instigating intimacy is something which is personal and which usually doesn’t happen quickly. However, sex is a basic human need which gives us the chance to connect emotionally with other people. If you’re ready to prevent sex from becoming yet another aspect of your life that is impacted by your eating disorder, it’s time to take steps to address the issue and to seek the support you need so that you can enjoy romantic relationships once more.

The Meadowglade is a residential facility that offers treatment for people dealing with eating disorders. Contact us today to find out if our facility could be the right fit for you!

Fight for yourself, not with yourself.

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