There are a multitude of physical, emotional and psychological consequences of eating disorders. One of the issues that we commonly get asked about is what impact eating disorders have on fertility – both short term and long term.
Concern about fertility is one of the most common reasons that women cite for seeking treatment for an eating disorder. Whilst we still don’t feel that there is enough research in this area to be able to give a definite statement about the long term impact of either anorexia or bulimia on fertility, we do know that women with current eating disorders are more likely to experience fertility problems.
It is fairly well known that in restrictive eating disorders, where periods stop due to low weight, fertility issues are very likely. However studies have also identified fertility difficulties in women with eating disorders who are at a healthy weight.
A research study done in 2013 (Int J Eat Disord 2013; 46:826–833) is the most recent study that we are aware of that investigated the impact of a current eating disorder on fertility. The researchers compared 2,257 women with a current diagnosis of an eating disorder with 9,028 women without an eating disorder. An advantage of this study is that it explored fertility issues in women across all eating disorder diagnoses: anorexia nervosa, bulimia nervosa, atypical eating disorder and binge eating disorder.
The researchers found that across all eating disorders, women were more likely to be childless. Whilst this doesn’t necessarily point to fertility problems in itself, it does support previous research in highlighting the presence of increased fertility difficulties in women with eating disorders. This research also found that women with bulimia nervosa or binge eating disorder were at increased risk of miscarriage.
Previous research has also found that in restrictive eating disorders with resulting low weight, up to 1/4 of patient may never regain normal menstruation cycles, suggesting that fertility may be affected even following successful treatment. In women that do become pregnant there is a known increased risk of complications like miscarriage, birth defects and low birth weight babies, Cesarean section, and postpartum depression.
We would reinforce that we don’t feel there is enough research at present to know what the long term fertility implications for people in recovery from an eating disorder are. There is some evidence though that fertility may not always return to normal once a person has fully recovered from an eating disorder. We would suggest that this is more likely if the eating disorder has been severe and long term.
I you are concerned about the impact of an eating disorder on your fertility, we would encourage you both to seek professional help and to be open about your eating disorder history with your GP or any other professional involved in your fertility care.