Anorexia nervosa: changes in sexuality during weight restoration

Objective: We examined changes in sexual drive during weight restoration in patients with anorexia nervosa. Methods: Eleven women with anorexia nervos a prospectively completed the Sexual Daydreaming Questionnaire (SDQ) and th e Hospital Anxiety and Depression Scale (HADS) at five time points during i npatient treatment involving weight restoration. SDQ and HADS scores were r ecorded every 4 weeks until 8 weeks after subjects had reached the mean mat ched population weight (MMPW), which was monitored against body mass index (BMI). Histories were taken for purging, self-cutting, childhood sexual abu se, and number of sexual partners. Repeated-measures analysis of variance, regression analyses, and t tests were performed. Results: BMI and sexual da ydreaming were closely associated (p < .001). BMI and depression also achie ved a statistically significant association (p = .046), with "caseness" for anxiety disorder throughout. Higher levels of sexual drive at MMPW seemed to be associated with purging, self-cutting, and childhood sexual abuse but not at low weight. Levels of sexual drive did not reflect previous sexual behavior. Conclusions: An increase in sexual drive accompanies weight resto ration in patients with anorexia nervosa, which is consistent with psycholo gical and physiological explanations of altered sexuality. Transient depres sion is also associated with weight gain. Changes in sexuality should be co nsidered in both recovery and treatment failure.