Sexual functioning of female eating-disordered patients

Abstract

Many theories about relating eating disorders with sexual development and experience have been proposed. The authors employed a normed psychometric instrument, the Derogatis Sexual Functioning Inventory (DSFI), to study empirically sexual characteristics of subtypes of eating‐disordered patients. Forty‐four female inpatients were divided into three subcategories; restricting anorexics (AR), bulimic anorexics (AB), and subjects exhibiting bulimia nervosa (BN). Starved anorexics were first allowed to attain their goal weight range before participating in the study. The three groups did not differ demographically. Comparing the eating‐disordered group as a whole to the DSFI norms showed these patients to have quite poor sexual functioning and satisfaction. The “Sexual Functioning Index” representing the global DSFI score put these patients below the first percentile when compared to the normative sample. Nine out of the ten scales of the DSFI failed to show a significant difference between patient subgroups. Only the “fantasy” scale distinguished the AR subgroup with its paucity of sexual fantasy from the BN subgroup who were in the average range, with AB in between. These results are somewhat contrary to other studies comparing outpatient bulimics and anorexics and suggest that patients with eating disorders severe enough to warrant hospitalization represent a more homogenous group regarding their psychosexual characteristics.

Sexual functioning in women with eating disorders

“…Consistent with these findings, women with BN symptomatology report an earlier age of sexual encounters and have more sex partners and higher sexual desire and fantasy compared with women with restricting AN 8, 12–14. Mangweth-Matzek et al 15 showed that women with AN and BN were similar to healthy controls in age at menarche and achievement of most sexual milestones, but rated their sexual experiences significantly more negatively than both a psychiatric and a healthy control group, corroborating earlier findings 14. Sexual concerns among women with AN are similar to concerns of women within other groups known to have sexual difficulties such as women with major depression and post-partum women 16…”

“…Small studies have suggested that women with restricting AN are less likely to have a romantic partner or to have engaged in sexual intercourse than women with BN 5, 8, 12. Consistent with these findings, women with BN symptomatology report an earlier age of sexual encounters and have more sex partners and higher sexual desire and fantasy compared with women with restricting AN 8, 12–14. Mangweth-Matzek et al 15 showed that women with AN and BN were similar to healthy controls in age at menarche and achievement of most sexual milestones, but rated their sexual experiences significantly more negatively than both a psychiatric and a healthy control group, corroborating earlier findings 14.…”

Body Image and Disordered Eating in Romantic Relationships

“…for some women with eWs concerns, even discussing sex is difficult (evans & Wertheim, 2002). sexual functioning also seems to suffer; women with clinical eating disorders have been shown to have poor sexual functioning and satisfaction when compared to a sample of women without eating disorders (rothschild, fagan, Woodall, & andersen, 1991). there is evidence for this relation at subclinical levels as well; body image concerns specific to physical intimacy with a partner predicted women's sexual experience and avoidance of sexual activity, even after controlling for weight, body image, general sexual anxiety, and psychological well-being (Wiederman, 2000).…”

The impact of sexual and physical abuse on eating disordered and psychiatric symptoms: A comparison of eating disordered and psychiatric inpatients

“…characterize anorexia as a response to sexual frustration or as a hysterical rejection of sexuality (Coovert, Kinder, & Thompson, 1989). Contemporary researchers have elaborated on this theme suggesting that the psychosexual development of bulimic and anorexic women is impaired (Crisp, 1981;Rothschild, Fagan, Woodall & Andersen, 1991 . ) More recently, clinicians hypothesize that sexually abusive experiences may increase a woman's risk of developing eating disordered behaviors.…”