Estimates of female factor infertility due to ovulatory failure range as high as 25%. In a majority of individuals, an exact cause cannot be found. The early detection of factors contributing to the development of anovulation is critical to the prevention of longer-term reproductive failure. Compromised nutritional status leads to a variety of pathological events that are of particular relevance to the maintenance of normal menstrual cyclicity. The final common pathway is presumed to ultimately involve impaired regulation of hypothalamic gonadotropin-releasing hormone (GnRH) secretion. We propose that pathological dieting behavior, prior to substantial weight loss or change in percentage of body fat, is the critical initiator in a cascade of psychobiological events resulting in chronic ovulatory dysfunction.