Recent research on body image indicates that dissatisfaction with weight sets in girls at a tender age of 6!!! Desire to become thin, anxiety about weight and shape, body image - these aren't common to teenage and adolescent years. The search for a 'diet' to lose weight by limiting calories or types of food begins by age 8. Irrespective of the age and gender, persons who diet are nearly 5 times more prone to developing a serious eating disorder.
Eating disorders affect a person's emotional and physical health. Not eating a good diet is denying the body nourishment and nutrition. A real, complex and devastating impact of eating disorder is fertility. The direct connection between nutritional intake and fertility cannot be ignored. Eating disorder robs a person of their talents, dreams, interests, passions and fertility as well.
Myths about eating disorders
Misconceptions and myths of eating disorders pose a hurdle to learn, unlearn and relearn. Below are a few statements which most of us have come across.
We have all the time in the world to learn things that need to be learned and less time to unlearn it. Understand eating disorders in a more inclusive way and it's devastating effect on fertility.
What actually is eating disorder?
Eating disorder isn't a physical illness. It is rather a mental illness that jeopardizes overall well-being. The Diagnostic and Statistical Manual of Mental disorders (DSM) have officially recognized eating disorder as Mental Disorder. Someone can be experiencing or developing an eating disorder. Generally, people do not accept and often try to hide their behavior. It's expressed as an abnormal or disturbed eating pattern or inadequate or excessive food intake.
How does one find out? Look for these physical, behavioral and psychological signs.
These are common signs. A person with an eating disorder may have one or a combination but not all. It just confirms the person's unhealthy relationship with food. Moreover, signs vary with eating disorder type.
Types of eating disorder
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a publication of the American Psychiatric Association (APA). The DSM5 (revised) has classified eating disorders.
Anorexia nervosa: Irrational fear of gaining weight, a strong desire to be thin and taking extreme steps to be thin. Criteria for anorexia are:
Bulimia nervosa: Translated from Greek, Bulimia nervosa means 'nervous ravenous hunger'. Obsessed with body and weight, persons with Bulimia take extreme efforts to avoid gaining weight often by cyclical purging following eating. Criteria for bulimia nervosa are:
Binge-eating disorder: Always over eating and bingeing and frustrated by weight gain. Criteria for binge-eating disorder are:
Other specified feeding and eating disorder (OFSED): It is a broader term which includes the following eating disorders such as:
Atypical anorexia nervosa: Criteria of anorexia nervosa sans low body weight.
Bulimia nervosa of Lower frequency: Criteria of Bulimia nervosa sans bingeing-purging cycles that occur less often than one time a week.
Binge-eating disorder of low frequency: Criteria of binge-eating disorder sans binge-eating episodes that occur less than once a week.
Purging disorder: Person purges without bingeing
Night eating syndrome: Person consumes low amounts of food during the day but eats a lot at night.
Avoidant/restrictive food intake disorder (ARFID): It is not body weight or shape or fear of becoming fat that influences food choice. Criteria for ARFID are:
Unspecified feeding and eating disorder: Persons do not meet the full criteria of any of the eating or feeding disorder criteria. Yet the eating habit causes great emotional upset or interferes with daily life.
The connection – Eating disorders and fertility
Is there a connection between eating disorders and fertility? Yes, fertility problems are a common side effect of eating disorders. Among women with a history of eating disorders, infertility and reproductive issues are common.
Demand for energy, nutrition is at an all-time high during child bearing years. But there is a fight on the outside i.e. image concern and inside, i.e. malnutrition. The effects of eating disorders on fertility are:
Of the different types of eating disorders, the effect of Anorexia is hazardous. Anorexia affects fertility by reducing chances of conceiving. Women with anorexia do not have menstrual cycles and in many instances periods abruptly stop.
For instance, a woman developed anorexia nervosa at the age of 14. After a long wait, she conceived through vitro fertilization. Post delivery, she found it hard to care for her baby's nutrition and just couldn't carry the baby in her arms because of muscle weakness. She confessed that she had difficulty in abandoning symptoms of anorexia nervosa with which she had lived for nearly 25 years.
Close to 50 % of women with Bulimia experience irregular menstrual cycles. Here is a story of a woman living with Bulimia or bulimia nervosa for 20 years. Her body wasn't getting enough nourishment. Nutrition was only available for vital functions of the body. Menstrual cycle was hit. Deprivation of enough nutrients led to onset of irregular menstrual cycle which disrupts ovulation, or releasing an egg, each month. She had very light periods, unpredictable and irregular periods or no periods at all. The challenge was obvious. Irregular periods made trying to conceive very challenging.
Now about binge eating disorder. She was just 20 years old. But all the time she could only think of food. Once, she ate an entire ½ gallon of cookies and ice cream in one sitting. Yet, couldn't stop craving for more. She was attracted to fatty foods with little or no nutritional value. Clearly, she was denying herself vital vitamins, protein and other nutrients.
Consuming too much food puts serious stress on the organs. It can damage stomach and crush the intestine. Besides, the most common effect of binge-eating disorder is obesity and overweight. Obesity in young women can result in high levels of the male hormones called androgens. Excess androgen and the imbalance can result in abnormal menstrual cycles and blocked ovulation. A woman's ability to get pregnant suffers.
The impact on fertility of the other eating disorders, OSFED, Avoidant/restrictive food intake disorder, unspecified feeding and eating disorders cannot be ruled out. The endocrine system is vital for fertility. All types of eating disorders affect a woman's endocrine system, which controls the production of reproductive and growth hormones. It impacts menstrual cycle health. Hormonal imbalance occurs and ability to reproduce may be impaired.
On the whole, a person with eating disorder is denying the body an opportunity to conceive naturally. The struggle with stress, anxiety and depression, smoking, excessive drinking add on to the existing issue and dampens pregnancy plans.
Revive fertility. Control eating disorders
There is hope. Treatment is available for eating disorders and fertility issues. For anyone struggling with eating disorders and yearning to conceive, the road to conception and pregnancy is clear. The first step is to feel more determined to get eating disorders under control and revive fertility. 75 to 80 % of women conceive after being successfully treated for an eating disorder. Treatment regimes look at eating disorder as a 'problem' to be solved. The treatment aims at getting the mind and body back to a healthy state.
Seek appointment with a health care provider. Discuss eating habits and behaviors before planning a pregnancy. It is necessary to seek treatment for the disorder before thinking of becoming pregnant. The healthcare provider may recommend a counselor who is experienced in treating people with eating disorders and a nutritionist who can help create a healthy eating plan to get to a healthy weight. There are many habits to let go off and relearn body acceptance and how to feed and honor your body with 'normalized eating'.
When the body is well fed, menstrual periods will become regular again and there should not be trouble getting pregnant. But if a woman still continues her struggles with ovulation issues, there are oral fertility drugs like clomiphene citrate (clomid or Serophene) which might be prescribed to stimulate hormones to help in ovulation.