Eating Disorders and Fertility Care
People seeking fertility care are significantly more likely than the general population to have an experience of body image issues, disordered eating or an eating disorder. This includes both past experiences of these challenges as well as those that arise while undergoing fertility care.
What is infertility and fertility care?
Infertility is the inability to achieve a natural pregnancy after twelve months or more of regular unprotected sexual intercourse (1). Infertility is estimated to affect one in every six people of reproductive age worldwide (1). Fertility care encompasses the prevention, diagnosis, and treatment of infertility.
What are eating disorders and disordered eating?
Eating disorders are serious, complex, and potentially life-threatening mental illnesses. They are characterised by disturbances in behaviours, thoughts, and attitudes to food, eating, and body weight or shape. Eating disorders have detrimental impacts upon a person’s life and can result in serious medical, psychiatric and psychosocial consequences. Some of the effects of an eating disorder can impact on fertility.
Eating disorders, disordered eating and body image issues in fertility care
It is important to note that not everyone who experiences fertility challenges will develop disordered eating or an eating disorder. However, people who are already susceptible to eating disorders may be at greater risk during fertility care due to the unique stressors and emotional demands associated with the process.
Among women experiencing infertility, body image concerns were reported by just under half (4). Among women pursuing fertility treatment, rates of current eating disorders range from 0.5 to 16.7%, while past eating disorder prevalence rates range from 1.4 to 27.5% (5). These rates are respectively four and seven times higher than those experienced by the general population. Disordered eating has also been reported in up to 48% of women seeking fertility treatment (5).
Rates of body image concerns and eating disorders are also high in women experiencing reproductive health conditions. In females diagnosed with PCOS, more than half experienced body image issues and 18% experienced eating disorders (4). In females diagnosed with endometriosis, 45% experienced body image issues and 12% experienced eating disorders (4).
Despite the high prevalence of eating disorders among this group, less than a third of women who have had a known eating disorder report this to their obstetrician or gynaecologist (6).
Information for people undergoing fertility treatment
NEDC has developed a resources specifically for people seeking fertility care. The booklet, Mind, Body & Fertility: The Connection Between Fertility Care, Disordered Eating and Eating Disorders, equips patients who may be experiencing or at risk of disordered eating or an eating disorder with information about the unique aspects of the relationship between fertility care and eating disorder risk, and includes practical preventative tips and other helpful suggestions.
Information for health professionals working in fertility care settings
NEDC has developed is comprehensive foundational eating disorder training developed specifically for fertility care professionals including obstetricians, gynecologists, mental health professionals, dietitians, nurses, naturopaths and herbalists. Eating Disorder Core Skills: eLearning for Fertility Care Professionals will equip fertility care professionals with the knowledge and skills to identify and respond when a person is experiencing an eating disorder, understand shared care in the stepped system of care, and prevent and minimise harm for eating disorders in the context of fertility care.
Access this free training from our website.
References
Hecht LM, Hadwiger A, Patel S, Hecht BR, Loree A, Ahmedani BK, Miller-Matero LR. Disordered eating and eating disorders among women seeking fertility treatment: A systematic review. Arch Womens Ment Health. 2022;25(1):21–32. doi: 10.1007/s00737-021-01156-x.
Le Floch M, Crohin A, Duverger P, Picard A, Legendre G, Riquin E. Prevalence and phenotype of eating disorders in assisted reproduction: a systematic review. Reprod Health. 2022;19(1):38. doi: 10.1186/s12978-0.