Eating Disorder Recovery and Healthy Sexuality

Jessica Juhnke MSW, LMSW


Sexuality is a complex topic that includes everything from our physical development to the people we choose to date. It is a difficult topic to define, and includes the way we interact with not only ourselves but other people in our lives with who we choose to share intimate experiences. Healthy sexuality includes being aware of your own needs, wants, and desires while also having the ability to share these with individuals who make you feel safe and valued.

Defining and expressing healthy sexuality can be difficult for anyone, regardless of whether or not you have an eating disorder. However individuals with eating disorders often share common characteristics such as distorted body image, low self-esteem, perfectionism, and shame that can become a barrier to healthy sexuality. In order for those with eating disorders to experience healthy sexuality, there are several components that must be in place.

1) Safety: Part of recovery from an eating disorder involves working towards the ability to feel safe in your own body. This same idea also applies to healthy sexuality. Feeling safe within your own body is a key part of finding comfort and pleasure in an intimate experience. This is often a difficult goal to accomplish for individuals who struggle with issues such as perfectionism, distorted body image, or discomfort in their bodies. Therefore, addressing these issues in treatment is an essential part of working towards healthy sexuality in the future.

2) Trust: Healthy sexuality involves being able to trust your body, which is difficult for those with eating disorders who may have spent years disregarding important internal body cues. Another essential component of healthy sexuality involves being able to trust your own needs and desires, which is difficult for those whose thoughts and desires are currently driven by an eating disorder. Spending time in treatment learning to trust internal cues, thoughts, needs, and desires is a key part of developing healthy sexuality.

3) Addressing Past Trauma: Both sexual trauma and eating disorders often cause individuals to experience high levels of shame, guilt, and discomfort in their own bodies. Sexual trauma can also lead to dissociation, flashbacks, hypervigilance, and mental health issues that make recovery from an eating disorder difficult. For those with have a history of sexual trauma, recovery from an eating disorder may also include working with a therapist to address past trauma that may be impacting or creating barriers to the recovery process.

4) Addressing Physical Health: Medical issues that often accompany eating disorders can have an impact on sexuality. Body weight and nutrition have a direct impact on many of the hormones that affect sexuality and libido. Mental health issues that can accompany eating disorders can also impact one’s ability to develop healthy sexuality, as can some medications used to treat them. While addressing medical issues during treatment, individuals may begin to see changes in their thoughts, desires, and needs that relate to sexuality.

Recovering from an eating disorder isn’t easy. Recovering from an eating disorder while working to identify what healthy sexuality looks like to you can seem especially overwhelming. However, as one learns to become more comfortable in their body, trust their internal cues, and identify their needs or desires, beginning to develop a concept of healthy sexuality becomes an easier next step.