Marlene Clark, a registered dietician who specializes in eating disorders at Cedars-Sinai Medical Center and co-author of Carrying a Little Extra: A Guide to Healthy Pregnancy for the Plus-Size Woman (Berkley Publishing Group, 2003), says that eating disorders can affect a woman's fertility, but the desire to become pregnant is so powerful that many women can overcome their problem – at least long enough to conceive and carry a pregnancy to term. But it's important to work with your doctor to address the problem and become healthy enough to get pregnant.

The two most common eating disorders are anorexia and bulimia. A person with anorexia strictly controls caloric intake, often to the point of near-starvation. Bulimics control calories through purging, or vomiting, after meals. Both anorexics and bulimics often exercise to excess and use laxatives and diuretics inappropriately. An overlap between the two disorders is not unusual.

To put it simply, in order to conceive, a woman must have a certain percentage of body fat. This not only controls our monthly cycles, it's what controls the onset of menstruation. As Clark points out in her book, once this cycle is established, it is body fat dependent.

When a person diets, most of the weight loss is fat. As a result, a relatively small percentage of weight loss can represent a large percentage of total body fat. This loss of body fat causes the body to conserve energy in any way it can. "Someone who is severely anorexic doesn't have enough body fat to support their own needs through the calories they're eating," says Clark. "The body recognizes that a pregnancy can't be supported, and ceases to menstruate because that's not a necessary function."

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