Anorexia or Anorexia Nervosa

Also see the entry for Bulimia

What It Is
An intense fear of gaining weight. Someone with anorexia obsesses about food and limits food intake, even though she or he is too thin. Anorexia is more than just a problem with food. It's a way of using food or starving oneself to feel more in control of life and to ease tension, anger, and anxiety.

Who Gets It
Most sufferers are girls or women

Symptoms
Someone with anorexia has a low body weight for her or his height, resists keeping a normal body weight, has an intense fear of gaining weight, thinks she or he is fat even when very thin, misses three menstrual periods in a row (for girls/women who have started having their periods)

How It's Diagnosed/Detected
Severe weight loss, possibly accompanied by depression, anxiety, obsessive behavior, substance abuse, problems with physical development. If not severe, these disorders (bulimia and anorexia) may not be obvious to an examining physician.

How It Affects Fertility (And Pregnancy)
In order to ovulate and maintain a pregnancy, a woman needs to have 17 percent body fat (and 22 percent body fat to begin menstruating as a girl). Many women with eating disorders–especially anorexia, which results in severe weight loss–have a lot less. Women with anorexia may have a BMI so low that their hormone production is disrupted and they do not ovulate. (Women with bulimia may appear to be normal weight, but may have severe nutritional deficiencies that can affect fertility). If you suffer from an eating disorder and want to be pregnant soon, tell your doctor about the problem. You should get your weight—and your nutrition—in shape before you try to conceive.

Treatment
Because anorexia is both a physical and emotional problem, the patient may need to see a doctor, a dietitian, and a counselor. While there are no medicines to treat anorexia, your doctor may prescribe an antidepressant or anti-anxiety drug. If the weight loss is severe, hospitalization may be required.

Pregnancy Prognosis
If a woman is somewhat underweight, she may be secreting some hormones but not in the precise amounts or at the correct time needed to ensure conception and a healthy pregnancy. The same can be true of women who weigh too little. According to experts if you’re not within 97 percent of your ideal weight on the Met Life charts, chances are you won’t be able to conceive or sustain a pregnancy. Even with IVF treatments, there’s a high rate of failure and miscarriage at that degree of slimness. Research from the Harvard Nurses’ Study 2 is anything but reassuring: Data on over 2,500 women suggested that those who were significantly under- or overweight at age 18 were more likely to experience trouble becoming pregnant at age 22 or older. Achieving a moderate, healthy weight at as young an age as possible may not only be important to our own health but to the next generation’s as well.