The sexual experience of women diagnosed with anorexia nervosa or bulimia nervosa

Int J Eat Disord. 1996 Mar;19(2):109-18. doi: 10.1002/(SICI)1098-108X(199603)19:2<109::AID-EAT1>3.0.CO;2-R.


Objective: Women with bulimia nervosa generally have reported greater sexual activity and experience relative to women with anorexia nervosa. However, past research has been based on small samples and has not controlled for potential confounding variables or symptom severity. We further investigated sexual experience among women diagnosed with an eating disorder.

Methods: Women evaluated in an outpatient eating disorders program, and subsequently diagnosed with either anorexia nervosa (n = 131) or bulimia nervosa (n = 319), completed the Diagnostic Survey for Eating Disorders-Revised (DSED-R) at intake. Sexual experience variables (masturbation, coitus, sexual satisfaction), as well as control variables (age, weight, and menarche) and measures of symptom severity, were derived from the DSED-R. Logistic regression analyses were used to predict sexual experience.

Results: After controlling for relevant covariates, bulimics were more likely than anorexics to have engaged in sexual intercourse. Masturbation experience, as well as self-ratings of current sexual satisfaction, were inversely related to degree of restriction of caloric intake, particularly among women with anorexia nervosa. When compared to anorexics, bulimics reported greater sexual interest and earlier age of first coitus.

Discussion: Coitus (sexual activity involving a partner) was related to eating disorder diagnosis independent of symptoms, whereas masturbation (self-focused sexual activity) was related to caloric restriction for the sample as a whole and anorexia nervosa patients in particular. These relationships between sexual experience and eating disorder symptoms and diagnosis may illuminate the personality features of women with anorexia nervosa versus bulimia nervosa as well as the functional role of caloric restriction.

MeSH terms

  • Adolescent
  • Adult
  • Anorexia Nervosa / diagnosis*
  • Anorexia Nervosa / psychology
  • Bulimia / diagnosis*
  • Bulimia / psychology
  • Child
  • Coitus
  • Energy Intake
  • Female
  • Humans
  • Masturbation / psychology
  • Middle Aged
  • Personality Assessment
  • Psychosexual Development
  • Sexual Behavior*