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Too Thin to Conceive

How Anorexia and Bulimia Impact Fertility

By Kelly Burgess

The effect of caloric restriction on conception isn't limited to women. Dr. Jack Katz, chairman of the department of psychiatry at North Shore University Hospital at Manhasset, says that an extreme drop in body fat has a similar effect on male fertility. "In males who are anorective, the analog to the cessation of menses is their sperm count drops once their weight gets below 15 to 20 percent of body," he says. "This causes their fertility to drop substantially. Once they gain weight, they can become fertile."

In bulimia, there often isn't this loss of body fat, as Dr. Katz points out, so bulimia may not affect conception. "We do have to differentiate between a normal-weight bulimic and women with anorexia," he says. "The rate of infertility in women who meet the criteria of anorexia nervosa is very high – I'd say close to 100 percent. Those who suffer from bulimia may ovulate. Certainly some can become pregnant, but whether you can maintain it is another story. It's not a healthy situation for the woman or for the pregnancy."

So if a man who is anorectic and begins to eat again can regain his fertility, is the same true for a woman? Yes, says Dr. Katz. Furthermore, although the long-term negative effects on bone mass with anorectics has been well-documented, there is no evidence that it has a long-term effect on fertility. Still, even though there's no research showing the "ideal" time between beginning a healthy diet and conception, Dr. Katz prefers that a woman has been eating healthfully and having periods for at least 6 to 9 months.

However, it's not always that simple. Women with eatingdisorders are extremely anxious about food, Clark says. While she may want to eat healthfully for her sake and her baby's sake, her eating disorder is part of her personal identity, and she may have difficulty giving that up.

Want to see more?

• Hormonally Speaking: How Hormones Affect the Fertility Cycle
• Eating Disorders and Pregnancy: Helping the Anorexic or Bulimic Mom-to-be
• The Skinny on Weight While Trying to Conceive: Conception for the Underweight
• Too Toxic to Conceive: Is Your Lifestyle to Blame for Your Inability to Conceive?
• Pregorexia: When Women Strive to Be Super Thin During Pregnancy
• Join the discussion on our Family.com community!

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