How Eating Disorders Impact Fertility
Out in the Open Now
Once a secretive and silent behavior, eating disorders have taken their toll on many young women and men. When Karen Carpenter, a young pop singer, lost her life to anorexia in February of 1983, her death triggered studies into a previously ignored arena. Now, nearly 30 years later, the known numbers are staggering. In the United States alone there are more than seven million women suffering with the devastation of eating disorders. The numbers are likely much higher as so many women with the illness remain secretive. Part of the physical impact of eating disorders, anorexia in particular, is the loss of fertility. Since the illness is found predominantly among young women of childbearing age, it is estimated that one in five women who seek fertility help are there because of an eating disorder.
Best Known and Most Common
Perhaps the best known eating disorder is anorexia nervosa, which is characterized by a distorted and unhealthy sense of body image accompanied by extreme dieting and starvation in order to control weight gain. Now recognized as a mental illness rather than a choice, anorexia affects nearly two percent of the American population. The anorexic has a perception of being fat and needing to lose weight, even when she is already dangerously thin. This belief drives her to erratic eating habits, self-starvation and excessive exercising. Obsessive-compulsive disorder (OCD) often exacerbates the need to be perfect and fuels the disorder.
Many times it is easy to pick out a woman who is suffering with anorexia. It is more difficult to determine who has bulimia. Even though bulimia is less obvious, it is more common. Binge eating then vomiting or using laxatives to purge excess calories characterize bulimia, which affects about five percent of the population. Because a bulimic is able to maintain a normal appearance and body weight the signs are less obvious and consequently the disorder often goes undetected.
How Eating Disorders Affect Fertility
The negative effects of eating disorders are myriad and far-reaching. Abdominal pain, constipation and fatigue are common signs of eating disorders. Organ damage to the liver, kidneys and heart is unseen and dangerous. Tooth decay, hair loss, anxiety and depression are yet other side effects. The negative effects include reproductive problems as well.
In order for a woman to conceive she must have a certain percentage of body fat. Body fat not only controls the monthly cycle, it also controls the onset of menstruation. Extreme dieting means a serious loss of body fat which puts the body into a state of preservation to conserve energy in any way it can. An anorexic doesn't eat enough calories for her body to support its own needs so certain functions shut down in order to conserve energy. One such function is menstruation. When amenorrhea happens it is virtually impossible for a woman to conceive. Women who have suffered with anorexia for a long period of time may not ever have periods again due to the permanent damage done to their bodies.
Additional fertility problems arise in the form of low libido, reduced egg quality, ovarian failure and poor uterine environment. Any of these problems contribute to infertility, making any function - from fertilization of the egg through carrying a pregnancy to term - at best difficult and at worst impossible.
How a Pregnancy is Impacted
Should a woman with an eating disorder manage to conceive, her pregnancy is high risk. The complications associated with eating disorders during pregnancy are serious and dangerous to both mother and baby. Delayed fetal growth, miscarriage, stillbirth, low birth weight and birth defects (especially blindness and mental retardation) are all possible issues for the baby. Gestational diabetes, preeclampsia, low amniotic fluid, placental separation and premature labor are but a few things that can impact the pregnancy. Additionally, taking laxatives, diuretics or other medications can harm a developing baby, causing malnourishment for both mother and child. If she is able to carry the baby to term, the mother will likely have problems breastfeeding and may have to deal with serious post-partum depression.
Is there Hope?
As dark as it all looks, there is hope. Treatment is available for eating disorders and, once treated and under managements, 75 to 80 percent of women who have overcome their eating disorder go on to conceive and carry a pregnancy to birth. Often, a successful pregnancy is the best help for a woman to gain mastery over the disorder. However, pregnancy risks don't disappear with treatment.
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