Eating disorders in the context of preconception care: fertility specialists’ knowledge, attitudes, and clinical practices

Objective(s) To gauge fertility specialists’ knowledge, clinical practices, and training needs in regard to eating disorders. Design Cross-sectional study. Settings Fertility clinics. Participants Eighty Australian and New Zealand fertility specialists who were members of the Fertility Society of Australia. Intervention(s) None. Main Outcome Measures(s) Responses to an anonymously completed online questionnaire. Result(s) Approximately 54% of doctors correctly identified the body mass index relevant to anorexia nervosa, and 30% identified menstrual disturbances for anorexia, while 63.8% of doctors incorrectly nominated maladaptive weight control behaviors as a characteristic of binge eating disorder. While clinicians (83.7%) agreed it was important to screen for eating disorders during preconception assessments, 35% routinely screened for eating disorders and 8.8% indicated that their clinics had clinical practice guidelines for management of eating disorders. A minority of participants (13.8%) felt satisfied with their level of university training in eating disorders, 37.5% of doctors felt confident in their ability to recognize symptoms of an eating disorder, and 96.2% indicated a need for further education and clinical guidelines. On most items examined, knowledge and clinical practices regarding eating disorders did not differ according to doctor gender or years of clinical experience working as a fertility specialist. Conclusion(s) Knowledge about eating disorders in the context of fertility treatment is important. This study highlights the uncertainty among fertility specialists in detecting features of eating disorders. The findings point to the importance of further education and training, including the development of clinical guidelines specific to fertility health care providers.