‘Sexual anorexia’ is a relatively new term, but it’s important to mention from the outset that this is not a subcategory of anorexia. Despite what the name suggests (more on this later), people with sexual anorexia will deny themselves emotional and physical sustenance, such as having relationships, sexual intimacy, touching, and more.

If you’re curious to learn more about what this means, what the signs are, what causes it, and how to handle it in yourself or in a partner, we’re putting this topic under a microscope so you can identify the potential signs in yourself and others.

At Augmentive, we aim to provide holistic, tailored mental health support to everyone so they can live their life to the fullest, so if you have questions about sexual anorexia or other sexual issues, we’re here to help.

What is sexual anorexia?

‘Sexual anorexia’ is described as a condition where someone will refuse any emotional and sensual sustenance (such as sex or relationships) in order to keep underlying trauma at bay. It may be simplified as the opposite of sex addiction, since people with a sex addiction will ‘binge’ on excessive sex and possibly dangerous behaviours, whereas those with sexual anorexia will purposefully deny themselves certain pleasures that could see them connect with others.

The term was first coined by sex addiction expert Dr. Patrick Carnes in his book "Sexual Anorexia: Overcoming Sexual Self-Hatred”, although this book has been seen as somewhat controversial due to its theory that sexual anorexia is a form of sex addiction. One study suggests that sexual anorexia actually lies at one end of a spectrum, with the other end being sexual addiction.

Why sexual anorexia called that?

You would be forgiven for assuming that the term sexual anorexia relates to eating disorders, but in fact the condition has nothing to do with restriction of food. In fact, it is thought of as an obsessive state in which the physical, mental and emotional task of avoiding sexual activity dominates one’s life.

The topic of sexual anorexia has been talked about more frequently in recent years, but many believe there is still a question mark over its legitimacy. At Augmentive, we believe this topic is worth learning more about, and perhaps can be seen as an umbrella term for a number of underlying sexual issues that can be explored with a qualified professional.

Throughout this article we will mention terms such as ‘sexual anorexia’, ‘sexual bulimia’ and ‘intimacy anorexia’ as these have been used elsewhere, but it’s important to note that to date, none of these terms appear in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), so many mental health professionals don’t recognise it. We don’t necessarily agree with the comparison to eating disorders, because anorexia and bulimia are not conditions that anyone ‘chooses’, and can be life threatening, however the current research on sexual anorexia/bulimia and intimacy anorexia describes it as a choice a person makes, and it is not a life threatening condition.

Isn’t sexual anorexia just a low sex drive?

No, it’s different. Low sex drive, also called low libido, is a low desire for sexual activity that can be a symptom of another physical or mental condition, whereas sexual anorexia is a complex condition with a psychological underlying cause.

Low sex drive can be caused by a number of factors such as hormonal imbalances, side effects of some medications, certain medical conditions, tiredness, stress, depression and more. People with low sex drive will avoid sex because they don’t feel like it, whereas people with sexual anorexia may avoid sex even if they do have a physical desire to engage in intimacy.

Interestingly, despite their aversion to sex, people living with sexual anorexia may still engage in sexual relationships, although it will not be easy for them.

What are the signs of sexual anorexia?

The main sign of sexual anorexia is of course an avoidance of sexual and emotional connection. Some other signs include:

• Feelings of fear or anger arising whenever the subject of sex comes up
• Taking extreme measures to avoid sex and intimacy (someone with sexual anorexia can become obsessed with avoiding sex to the point where it dominates their life)
• Feelings of fear when attracted to someone
• Feelings of fear when thinking about their own sexuality
• Self-judgement
• Self-doubt when it comes to sex
• A deprivation of sexual and emotional pleasure and connection with others
• Engaging in compulsive behaviours in order to hide or compensate for sexual anorexia, for example, isolating themselves from others, pursuing relationships with emotionally unavailable people, having vivid fantasies, excessive masturbation or pornography use, and more

What causes sexual anorexia?

Sexual anorexia can affect all genders, and tends to impact those who have a history of past sexual abuse or sexual rejection, as well as those who identify with certain cultural, social or religious groups that encourage sexual repression.

In many cases, they may be completely unaware of the reasons behind their sexual anorexia and relationship issues, which is where working with a therapist can be incredibly helpful, especially since it is believed that people with sexual anorexia can also suffer from issues with other addictive behaviours, such as food addictions, substance addictions and more.

How is sexual anorexia related to sex addiction?

Psychologists working with people with sexual anorexia have found that some people with the condition may go through cycles where they experience sex addiction too, which can feel a little confusing to the person suffering. For some, sexual anorexia and sexual addiction are rooted in the same belief system which comes down to a desire to maintain control in one’s life. That said, sexual anorexia symptoms and underlying causes will be different for everyone, so it’s important to speak to a professional with experience regarding sexual issues so they can help you learn more about your potential condition.

As well as sexual anorexia, the term ‘sexual bulimia’ is also sometimes used (although rarely) to describe a slightly different version of the condition, but one that highlights the idea that sexual anorexia is closely related to sexual addiction. For example, sex addicts may find it easy to have one night stands with strangers, but may be scared to attempt any kind of intimate, committed relationship. This can cause a cycle of bingeing and purging, referred to as ‘sexual bulimia’.

What is ‘reactive intimacy anorexia’?

Another term that comes up when discussing sexual anorexia is ‘intimacy anorexia’, which is another name for sexual anorexia; both refer to sexual closeness and intimate, emotional closeness.

‘Reactive intimacy anorexia’ is the response a person may give when their partner is experiencing sexual anorexia. For example, if one partner has sexual anorexia, the other may begin to feel ‘reactive intimacy anorexia’ where they themselves start to avoid sex due to the rejection they have experienced from their partner in the past.

How to handle sexual anorexia if you think you may have it

In many cases, sexual anorexia and other related conditions are a result of things that may have happened during childhood, so reaching out for professional help is often the best way to address any underlying issues. At the core of sexual anorexia is an addiction to holding back intimacy, so it can be difficult to open up and take the first step towards finding help. Seeking support from an experienced sex and relationship therapist is often the most helpful way to begin addressing intimacy issues.

If you believe your issues could be simply related to a low sex drive due to, for example, certain medications like antidepressants, your doctor may be able to help you address this. Adults who suffer from inhibited sexual desire because of low testosterone or oestrogen levels may benefit from medical treatment, and menopausal women with low sexual desire may also benefit from hormone replacement therapy to help boost libido.

When managing your sexual anorexia within a relationship, try to keep the lines of communication open with your partner so they don’t feel rejected. If you struggle with sexual touch and affection, try to focus on nonsexual affection instead while you work through your challenges with a therapist. This should help you maintain a connection with your partner.

How to handle sexual anorexia if you think your partner may have it

If you think your partner is experiencing sexual anorexia, you may be feeling all sorts of things, from frustration at the situation, to guilt about not being able to help them work through their issues. It is always best to suggest they work together with a professional to address the underlying causes.

Remember in some cases this can take a long time to untangle and work through, so it is important to be patient during the process and be open to understanding where their underlying feelings of sexual avoidance are coming from. By working through the advice and suggestions of a therapist you can keep moving towards a more open, intimate relationship.

Whether you’re feeling off-kilter or want to shake up your routine, our state-of-the-art mental wellbeing platform gives you quick and seamless access to world-class support on your terms, from private mental health assessments and reviews, to finding qualified and approved mental health professionals for the support you need: join us today.

If you have a question about sexual anorexia or think you may need advice and treatment, we’re here to assist on your journey. Our free 15 minute consultation can guide you to the most relevant specialists to answer your questions and discuss next steps.

DISCLAIMER: The content published by Augmentive is not designed to treat, diagnose, cure, or prevent any disease or condition. Always consult your GP or a qualified healthcare provider with any questions regarding a medical condition and before starting any therapy, diet, exercise, or any other health-related programme.