Eating disorders, such as bulimia nervosa, can negatively impact your health in different ways. Bulimia is an eating disorder characterized by cycles of binge eating followed by compensatory behaviors.
Compensatory behaviors are behaviors someone uses to avoid weight gain after binging. These behaviors include purging, fasting, laxative abuse, or excessive exercise.
Even though people with bulimia can be at a “normal” weight, bulimia can still affect fertility.  In fact, some research shows that about 17% of the people in fertility clinics are struggling with disordered eating. 
Bulimia and the Reproductive System
The reproductive system is a group of organs that controls our ability to reproduce. Male and female bodies have different reproductive organs, but they’re both designed to make reproduction possible.
The reproductive system doesn’t operate alone and is intimately intertwined with other bodily systems, primarily the endocrine system. The endocrine system manages hormones. Bulimia can impact the endocrine system, which can disrupt your reproductive system. 
Even if you aren’t looking to get pregnant right now, it’s important for your reproductive system to be functioning optimally. Any negative shift in your body signals that your body is being impacted by the eating disorder.
Bulimia and Menstruation
Bulimia can impact your menstrual cycle.  Menstrual changes include irregular periods or complete loss of your cycle, which is known as amenorrhea. 
About 50% of people with bulimia lose their period.  While it’s technically still possible to get pregnant even if you lose your period, it’s very unlikely. 
Bulimia and Men’s Fertility
Bulimia predominantly impacts girls and women.  However, men can struggle with bulimia too. Men may also experience changes in their reproductive system as a result.  Sperm quality and sperm count can be negatively impacted. 
Bulimia and Pregnancy
It’s possible to have bulimia and get pregnant. Unfortunately, bulimia can impact your ability to carry a pregnancy to term or have a healthy pregnancy.  Some potential consequences of bulimia during pregnancy include: [1,5]
- Bone loss for the pregnant person
- Growth restrictions for the baby
- Fetal developmental problems
- Low birth weight due to lack of nutrients
- Fatigue beyond what is normal in pregnancy
- Electrolyte abnormalities
- Lower APGAR scores at birth
- Increased risk of prolonged labor
- Increased risk of miscarriage
If you are pregnant and struggling with bulimia, it’s important to talk with your doctor about this. There are hormone treatments that can support you and your baby during pregnancy.  Possible fertility treatments for someone with bulimia include: [1,7]
- Ovulation induction: Hormonal medications can stimulate ovulation. Ovulation is when a woman’s body releases an egg, which makes conception possible
- Assisted Reproductive Technology (ART): Any procedure that involves taking a woman’s eggs, combining them with sperm, and returning the eggs to a woman’s body.
Some research shows that pregnancy can be triggering for people with bulimia.  Normal body changes, such as weight gain, during pregnancy, might increase body image concerns or make it more tempting to engage in disordered eating behaviors.
This might be especially true for women going through fertility treatments, as it’s normal to experience abdominal bloating and discomfort as a result of the hormonal medications. 
Similarly, during pregnancy or fertility treatments, women may be advised to lose weight if they are in a bigger body.  For someone with bulimia or a history of disordered eating, this can trigger a relapse. 
Fertility and Eating Disorder Recovery
It’s possible for your reproductive and endocrine system to heal after eating disorder recovery.  It might take some time because it can take a while for your nutritional stores to replenish after prolonged disordered eating. 
However, there can be significant barriers to accessing treatment, especially for people who are trying to conceive or are pregnant. You may feel ashamed or embarrassed to talk with your medical or mental health provider about their struggles with food or body image.
If this is true for you, it’s important to talk to your doctor about your struggles with eating, even though it might be a difficult conversation. You’re not alone in your struggle. Millions of people in America struggle with an eating disorder. 
If you are struggling with bulimia and are pregnant or trying to conceive, there are treatment options for you. You can find a treatment provider by talking with your doctor, mental health professional or searching for eating disorder professionals near you.
 Hecht, L.M., Hadwiger, A., Patel, S., Hecht, B.R., Loree, A., Ahmedani, B.K., Miller-Matero, L.R. (2021). Disordered eating and eating disorders among women seek fertility treatment: A systematic review. Archives of women’s mental health, 25, 21-32.
 Synder. (2014). Eating disorders in adolescents and young adult women: Implications for reproductive health. Contemporary OBGYN. Retrieved November 29th, 2021 from https://www.contemporaryobgyn.net/view/eating-disorders-adolescents-and-young-adult-women-implications-reproductive-health
 National Eating Disorders Association. (n.d). Statistics and Research on Eating Disorders. Retrieved July 1st, 2022 from https://www.nationaleatingdisorders.org/statistics-research-eating-disorders
 Green, J. (2014). Can Eating Disorders Cause Male Infertility? Center for Vasectomy Reversal. Retrieved November 29th, 2021 from https://www.vasectomyreversalflorida.com/blog/2018/07/can-eating-disorders-cause-male-infertility/
 Lindberg, S. (2020, September 28). Could you be experiencing “Pregorexia?” Here’s how to break the cycle. Healthline. RetrievedSy November 29th, 2021 from https://www.healthline.com/health/pregnancy/pregorexia
 Tessler-Karfunkel, E. (2014). Eating disorders: The hidden hormonal effect on fertility. The Science Journal of the Lander College of Arts and Sciences, 8(1), 42-50.
 Centers for Disease Control and Prevention. (2019, October 8). Assisted Reproductive Technology. Retrieved July 1st, 2022 from https://www.cdc.gov/art/whatis.html
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At Eating Disorder Solutions, compassion is at the root of everything we do. We understand that eating disorders are complex, deeply rooted mental health and medical conditions which require personalized treatment for a successful recovery. By integrating behavioral health modalities and clinical interventions, we endeavor to address disordered eating at its source.
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Published on July 7, 2022. Published on EatingDisorderHope.com
Reviewed & Approved by Jacquelyn Ekern, MS, LPC on July 12, 2022