What You Should Know About Sex During Eating Disorder Recovery
We all have complicated and at times unhealthy relationships with food. If you’ve lived with an eating disorder, though, you know that healing your relationship to food and to yourself can be a challenging process that continues throughout your lifetime. Recovery from bulimia, anorexia, binge eating and other EDs is consuming and impacts all aspects of one’s behavior, including sex.
According to a study released in 2011 involving 242 women with EDs, 66.9 percent experienced decreased libido, and 592 percent experienced sexual anxiety. In other words, if you live or are recovering from an eating disorder and sex is an emotional and physical challenge for you, you are not alone. Restricting fat can result in reduced estrogen, and reduced estrogen can lead to reduced testosterone and with that goes the sex drive.
“It’s important to know that the behavior of restricting food intake can impact the physical aspects of your body that make up your sex drive,” says Morgan Statt, a safety investigator with ConsumerSafety.org. “Specifically for women with anorexia, the malnutrition can change the way nervous system neurotransmitters function, resulting in a decreased libido.”
Treatment for EDs involves a combination of psychotherapy (individual and/or group), medication, nutrition counseling and medical care. Psychiatric medicines like antidepressants and mood stabilizers can impact your sex drive, although this can be a temporary side effect, and can sometimes be changed by adjusting your dosage or switching to a new medication.
Recovering from an ED is as much about healing your relationship with your body as it is about healing your relationship with food. You might want to have sex, but be uncertain or afraid of sharing your body with someone. Your sex drive might increase as you maintain the weight that’s right for you and as you work through the source of your ED with a therapist. Or you might be completely consumed with the task of recalibrating your mind around the lifestyle changes you’re making in recovery.
“Negative thoughts may arise during sex about your body, you may feel uncomfortable being touched and it may be difficult to be fully present,” says Kimberly Hershenson, a New York City-based therapist who treats patients with EDs. "Sex may not be enjoyable while you are still adjusting mentally and physically, but that’s OK.”
Hershenson stresses that while your mind and body are in flux (your periods might also be irregular during recovery, as they might have been before), things can return to normal, and you can enjoy sex again.
“Be patient and gentle with yourself,” says psychotherapist Brooke Novick. “Allow yourself time on this journey to heal, grow and bloom. Know that it is OK if you are not where you would like to be today.”
It’s one thing, of course, to navigate the experience of sex during ED recovery in your own mind, but what about with a partner? What should they know in order to help you feel good about sex and to support you?
“It may be difficult for your partner who is in early recovery to be intimate as often as you would like them to be,” says Novick. For instance, their energy may be focused on following a food plan and not engaging in ED behaviors that they may not have enough time or energy to consider sex.
“This lifestyle will become easier as they progress, but at first, it will take a lot out of them and it will be difficult.” Novick also advises that partners of folks in ED recovery should not take lack of interest in sex personally and that they might want to consider couples therapy for processing feelings that arise so the onus for handling the emotions of the person who isn’t in recovery doesn’t fall on the person who is.
In "Sex and Eating Disorders: A Guide" published in Ravishly in 2015, author Melissa Fabello, in ED recovery herself, urges partners of ED survivors to consider the complexities of their loved one’s relationship to their body and to give them the opportunity to talk about what’s comfortable or triggering for them before an intimate situation arises.
Also, rid yourself of the idea that you can presume to know anything about their experience (even if you’ve been in a relationship with or known someone with an ED before — every person is different). An eating disorder can be about control, but it can also be a coping mechanism for trauma. “Don’t ever assume that because you understand someone’s eating disorder history that you suddenly understand their sexual history, too — or vice versa,” writes Fabello.
As a person in recovery, your highest priority is taking care of yourself and being kind to yourself while you do that. You don’t need to be in any situations that are causing you further stress as you heal, and that includes relationships, sexual or not. “Take recovery one day at a time,” says Hershenson. “It becomes too overwhelming to think that you must maintain recovery behaviors for the rest of your life. Just get through the day following your plan and worry about tomorrow and what the day brings tomorrow.”