Eating disorders have potential to significantly impact growth and sexual development, particularly when associated with malnutrition. The hypothalamic-pituitary-gonadal axis, which dictates puberty and sexual maturation, including bone growth, is sensitive to metabolic changes such as those in eating disorders. Consequences may include pubertal delay/arrest, stunted growth, weakened bones, menstrual changes, impotence, sexual dysfunction, infertility, or adverse pregnancy outcomes. The physical and psychological impacts of eating disorders can also affect intimate relationships and sexual satisfaction. Visits to mental health providers offer an opportunity to assess the development and reproductive health concerns of patients with eating disorders. The purpose of this article is to review the epidemiology, pathophysiology, and morbidities of the reproductive sequelae of eating disorders and to educate mental health providers on when to refer patients for further medical evaluation.