Yes, Eating Disorders Affect Your Sex Life
Here’s one thing that we don’t talk about enough- how eating disorders impact someone’s sex life. So, what gets in the way of bringing awareness to the impact of eating disorders on sexuality? Here are a few reasons why these discussions aren’t given precedence:
Eating disorders are physical and mental health emergencies. As such, medical stabilization and nutritional rehabilitation are the top priorities.
Providers may perceive that they lack the knowledge/expertise to address this, and/or feel uncomfortable discussing sexuality with patients/clients.
Patients/clients may feel embarrassed or ashamed discussing their sexuality and sex life. These discussions run the risk of activating old trauma, require a trusting relationship and degree of vulnerability, and clients may think that this topic doesn’t relate to their eating disorder.
Photo by Connor Backer (@connorbaker via Unsplash)
Eating behaviors and sex are connected because they’re both basic needs, and because pleasure is central to both eating and sex. It’s not uncommon that changes to eating mirror changes in someone’s sex life.
In this post I’ll briefly summarize background information about eating disorders and three ways that eating disorders impact sexual functioning.
A Little Bit About Eating Disorders
Eating (and feeding) disorders are psychological and physical disorders that are characterized by a constellation of symptoms and abnormal eating behaviors that constitute a health crisis. Eating disorders disrupt a person’s physical, mental, and emotional health, functioning, and well-being. These biologically influenced illnesses are not choices, and people may look “healthy” but be extremely ill. Eating disorders affect people of all genders, ages, races, ethnicities, body shapes, weights, and sexual orientations, carrying an increased risk for suicide and medical complications.
Restriction or deprivation (not just of food, but of many other needs) is a common thread among all eating disorders. Unfortunately, restriction or deprivation is often not readily recognizable or visible to the affected individual (or providers) because it can be subtle or socially sanctioned (e.g., dieting, not allowing others to see your emotions, etc.).
When our needs aren’t being met, our extraordinary brains go to great lengths to ensure our survival. A stressed system has a difficult time functioning properly, even if things on the outside look “normal.” A simple way of understanding this is when your smartphone has a low battery and the phone switches to low power mode. The phone is still “on,” but certain features are deactivated in order to conserve power.
Your amazing body functions much in the same way. If our needs aren’t getting met (especially our energy needs) and/or our livelihood is threatened, our brain will respond by reducing our metabolic rate. A reduced metabolic rate can lead to symptoms like:
Slowed heart rate & low blood pressure (fatigue, dizziness, fainting)
Slowed digestion (bloating, constipation, nausea, early fullness)
Decreased sex hormones (we’ll discuss this more below), menstrual irregularities (for people who menstruate)
Increased risk for infections
Anemia (fatigue)
Dry/brittle skin & nails, hair loss
Moodiness, lack of concentration, anxiety, hypervigilance
Any, or all, of these signs indicate that something is amiss! If you feel like you’re in “low power mode”, chances are that this will have a significant impact on your sex life. For more on this, keeping reading!
Eating Disorders & Sexual Functioning
A reduced metabolic rate will lead to a body that is too stressed to reproduce. The brain adapts by decreasing the production of sex hormones to conserve energy. Reproduction isn’t necessary for individual survival and the brain will prioritize sending energy to life-sustaining organs like your heart, lungs, brain, and so on. This is an example of your body going into “low power mode.”
Decreased sex hormones lead to low sex drive, menstrual irregularities for persons who menstruate, and body density loss. Ultimately this can lead to fertility issues and sexual dysfunction. I’d like to focus specifically on how restriction and deprivation from eating disorders impacts someone’s sex life.
Eating disorders impact sexual functioning in three main ways:
1) Changes to sexual desire: Decreased sex hormones lead to low sex drive and a state of hypoarousal. Many people will report this as a loss of interest in sex, difficulty becoming sexually aroused, difficulty maintaining sexual arousal, and general lack of pleasure in sex. Further, feeling fatigued and dizzy will reduce your sexual desire. Finally, body changes (actual or perceived) can impact how sexually desirable you feel. That’s just changes to your own sexual desire….all of these changes will have an impact on your partner or partners’ arousal and experience (when/if you have a partner or sexual partners). Connection to yourself and others is a vital part of sexual experiences. An eating disorder can wreak havoc on your functioning and sense of embodiment.
2) Changes to sexual performance: Being preoccupied with food, your weight, and actual/perceived body changes can distract you and interfere with sexual performance. Preoccupation, moodiness, and lack of concentration are like uninvited guests- distracting, annoying, and tiring!! Another consideration is the physical discomfort that arises with GI symptoms and general fatigue. Discomfort and fatigue can impact your performance and pleasure, as well as your partner/partners’ performance (thus, impacting pleasure with the sexual experience). Finally, decreased sex hormones can impact performance via low arousal. This often will be reported as discomfort (e.g., vaginal dryness during vaginal sex), reduced duration of the sexual experience, difficulty achieving orgasm, etc.
3) Changes to sexual pleasure and satisfaction: The anxious brain is hypervigilant and rigid; neither of these conditions make for a pleasurable sexual experience. When you’re anxious, it’s much more likely that you’re disconnected from your body (and/or your partner’s body or partners’ bodies) which can impact sexual pleasure and satisfaction. Impaired sexual arousal and changes to sexual performance will likely impact pleasure and satisfaction. All of these are related!
The goal of this post was to bring awareness to the impact of eating disorders on sexuality. As a way of summarizing, here are a few key points:
Eating disorders are physical and psychological illnesses that impact physical, mental, emotional, and sexual functioning.
Deprivation and restriction (in any area, but especially energy restriction) leads to decreased sex hormones which impacts sexual arousal, sexual desire, sexual performance, and sexual pleasure.
Eating disorders impact physical sexual functioning as a result of decreased sex hormones, changes in energy level, fatigue, and bodily discomforts.
The mental and emotional toll of eating disorders including anxiety, mood changes, body image disturbances, and preoccupation with food/eating/weight can significantly impact sexual desire, performance, and pleasure.