Eating Disorders and Trauma
Mental Health & Substance Abuse

Eating Disorders
and Trauma

Trauma can negatively affect a person in a number of ways. Studies suggest that childhood abuse and adult victimization can contribute heavily to the development of bulimia nervosa, binge eating disorder, and anorexia nervosa.
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The Relationship Between Eating Disorders & Trauma

Approximately 28.8 million Americans will have an eating disorder (ED) in their lifetime. If untreated, an ED can cause serious health risks and emotional damage. Eating disorders are among the most deadly mental illnesses in the world.  

A common risk factor for Eating Disorders is trauma. Trauma is a common experience that nearly 60% of men and 50% of women will go through at least once in their lifetime. 

The vast majority of people with ED have reported at least one traumatic event in their past. Treatment for both trauma and eating disorders should occur at the same time to receive the best results. Seeking proper treatment is critical to health and well-being.

Defining Eating Disorders

Eating disorders are behavioral conditions that center around food behaviors that are persistent and severe. These behaviors are commonly associated with distressing thoughts and emotions surrounding food or weight. 

ED is often associated with preoccupations with food, weight, or shape. Another common association is anxiety about eating or the preoccupation with the consequences of food.

Common ED behaviors include restrictive eating, binge eating, or purging. Restrictive eating can manifest itself in the restriction of all foods or a particular food. Binge eating behaviors are those that an individual will eat past the point of being full and may eat large quantities of food in a short period of time. Purging behaviors can include vomiting, the use of laxatives, or over-exercising. 

Treatment for these disorders should address psychological, behavioral, nutritional, and other medical complications. All of these are affected by eating disorders and are essential in finding recovery. 

Types of Eating Disorders

The term eating disorders is broad, so this term is often broken down into categories that are diagnoseable. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is a diagnostic tool published by the American Psychiatric Association that includes diagnoses for eating disorders. 

According to the DSM-5, all of the below sub-categories of eating disorders are diagnoseable:

People with Anorexia Nervosa focus on weight loss and low BMI due to fear or phobia of gaining weight. This eating disorder has the highest mortality rate among all mental health disorders. The two types of anorexia nervosa are the restricting type and the binge/purge type.

People with Bulimia Nervosa engage in a cycle of behavior that involves binge eating and restrictive behaviors like purging, fasting, excessive exercise, or the use of laxatives.

People with Binge Eating Disorder (BED) engage in binging behaviors like eating past the point of fullness. These behaviors are often secretive because of feelings of shame and distress.

Other Specified Feeding and Eating Disorder (OSFED) is a diagnosis used when an individual does not meet all the specifications of the other eating disorder subtypes. Examples: atypical anorexia nervosa, purging disorder, and night eating syndrome.

People with Avoidant Restrictive Food Intake Disorder (ARFID) engage in restrictive behaviors not related to the desire to lose weight or to have a low BMI. Sensitivity to sensory characteristics, low appeal to food, and irrational fear of food may all be ARFID behaviors.

Causes of Eating Disorders

Scientists are still learning about the causes of eating disorders because they are complex mental health disorders. Experts believe the cause of this complex disorder may be due to trying to cope with overwhelming or painful emotions with food and food behaviors. Although there is no one cause of eating disorders, however, there are risk factors that can increase the likelihood of developing an ED. 

Common risk factors for eating disorders include but are not limited to:

Having relatives that have an ED increases the risk of developing one yourself. The neurotransmitter Serotonin may also be linked to an increased risk. 

Cultural influences and media tend to portray the ideal body for women as thin and the ideal body for men as muscular. These ideals can place pressure on people to conform to these standards by any means. 

Peer Pressure can come in the form of mockery or bullying about body type, size, or weight and can lead to developing an ED. 

The personality trait of perfectionism, impulsive behaviors, and difficulty with relationships can lead to lower self-esteem and the development of an eating disorder.

A history of any type of abuse or other distressful events can lead to eating disorder behaviors and increase the risk of developing an Eating Disorder.

Trauma as a Risk Factor For Eating Disorders

Trauma is a result of experiencing or witnessing a distressing event. Trauma can have lasting, adverse effects that affect physical, emotional, mental, spiritual, and social wellbeing.

Examples of events that can cause trauma include: 

Trauma of all kinds can be seen as a risk factor/cause for eating disorders. One study found that 67% of participants had both an eating disorder and an experience with at least one traumatic event. 

When trauma is long-lasting and begins to affect day-to-day life, the trauma can turn into post-traumatic stress disorder (PTSD). Studies have shown that 24.3% of men and women who have eating disorders also have experienced PTSD related to traumatic incidents. PTSD and ED seem to occur simultaneously due to having risk factors and causes in common.

Sexual abuse in childhood is also common in people who are diagnosed with an ED. About 30% of people with eating disorders have experienced sexual abuse in childhood. Most commonly childhood sexual abuse is seen in people with binge eating disorder and bulimia nervosa.

Eating Disorder and Trauma Treatment

If trauma is present in addition to an eating disorder, the best practice is to treat both issues at the same time. Trauma can hinder the recovery process if it goes untreated. Once the body has been nourished, therapeutic methods can be utilized to help work through the traumatic experience.

Trauma Treatment

To treat trauma and PTSD these therapeutic modalities are often used:

Prolonged exposure therapy (PE) is a type of CBT that helps gradually approach trauma-related memories, feelings, or situations with the help of a therapist.

Eye Movement Desensitization and Reprocessing (EMDR) reprocess traumatic experiences by using dialogue, memories, and eye movements with the help of a therapist. EMDR can help desensitize from trauma and triggers to relive the memory.

Cognitive Behavioral Therapy (CBT) is an evidence-based psychotherapy that recognizes that emotions and thoughts can be changed and can result in new behaviors. For PTSD, CBT can be applied directly to the traumatic memory.

Eating Disorder Treatment

To treat eating disorders these methods are often used:

Cognitive Behavioral Therapy (CBT) is an evidence-based psychotherapy that encourages diaries of food and eating behaviors, how to change eating and thought patterns, and how to predict symptoms. 

Nutritional Education involves working with a registered dietitian to create a meal plan and gain an understanding of the relationship with food.

Final Thoughts

Eating disorders and trauma commonly occur at the same time. There are a vast amount of diagnosable subcategories for ED and many distressing experiences can result in trauma. If untreated, both ED and trauma can cause serious physical, emotional, spiritual, and behavioral health issues. 

Trauma and an ED should be treated at the same time for the best chances of recovery. Therapeutic methods can be used to treat both the experience and disorder.  

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From all of us at New Method Wellness co-occurring treatment center, we wish you peace and serenity in knowing that you or your loved one will get the necessary help.

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