The Powerful Connection between Trauma & Eating Disorders

By Timberline Knolls Staff

Untreated trauma can disrupt your daily life — including your relationship with food and your body.

There’s a powerful link between eating disorders and trauma-related concerns such as posttraumatic stress disorder (PTSD). The National Comorbidity Survey-Replication Study found that approximately 80% of people who struggled with behaviors such as restricting their food intake or bingeing and purging also reported exposure to trauma [1].

In a study of more than 100 adult female patients who have anorexia nervosa or bulimia nervosa, 95% of the respondents reported experiencing at least one traumatic event at some point in their life. The highest number of traumatic experiences the participants reported was 11, while the average number the participants said that they experienced was four [2].

There are many different types of experiences that can be traumatic, but what connects them is that they can make a person feel like they’ve lost a sense of control or fear for their life. For the women in the study, the most common traumatic events they experienced included a life-threatening illness, the death of a loved one, and sexual assault.

Not everyone who experiences a trauma develops posttraumatic stress disorder, but about 24% of the study participants also suffered from PTSD. And nearly 70% of the participants said that they experienced their first traumatic event before they started struggling with symptoms of an eating disorder.

Understanding Trauma & Eating Disorders

So, what ties these complex conditions together? Researchers conducted five focus groups and two in-depth interviews with 20 female veterans, including one transgender woman, to understand the relationship between trauma exposure and eating disorders [1].

The participants consisted of a racially diverse group of women, with more than half being women of color (55%), including four Black women (20%), one Asian American woman (5%), and six women who reported their race as “other” (30%).

The researchers chose the participants based on their exposure to trauma and their histories of eating disorder symptoms. At the conclusion of the study, they identified three themes that connected these conditions:

• Because of troubling or negative emotions – Some participants turned to food because they had painful or negative thoughts or emotions. In some cases, they overate because they felt enraged about the trauma they experienced. In others, they used food to punish themselves because they felt shame or guilt. Whatever they were feeling, those emotions were reflected in their eating behaviors.
• To alleviate troubling or negative emotions – Other participants found comfort or relief from troubling thoughts or feelings from the way they ate. Food helped many participants ease anxiety, cope with anger, or create positive sensations after negative experiences. Others used food to numb negative feelings or emotions.
• To avoid unwanted attention from perpetrators – Those who had suffered interpersonal trauma said that they engaged in disordered eating behaviors to change their weight or body shape to avoid suffering another trauma in the future. The researchers noted that their goal was to make themselves invisible to those they deemed threatening and to regain a sense of control.

Because everyone’s experiences are so different, this study offers just a glimpse at how trauma and eating disorders might affect a person. The researchers’ findings highlight how important it is to gain an understanding of the root causes of a person’s struggles with an eating disorder — including whether they have a history of trauma.

Trauma-Informed Eating Disorder Treatment
When you’re living with an eating disorder, you may not even realize that the compulsions you’re struggling with have any connection with trauma from your past. Fortunately, there are eating disorder treatment programs that use a trauma-informed approach to ensure that you receive holistic care.

You should always complete a comprehensive evaluation before taking part in eating disorder treatment so that your care team can customize your plan of care to your specific needs. This will also help your care team determine whether you may benefit from a trauma-based approach.

Trauma-informed eating disorder treatment programs typically help participants process the traumatic experiences that have been barriers to their recovery. These programs also help participants learn healthier coping strategies and relapse prevention skills to better prepare them for life’s stressors and challenges.

Living with these two conditions might seem unmanageable right now, but with appropriate treatment that uses a trauma-informed approach, it’s possible to manage the symptoms you’ve been struggling with and live the life you deserve.

References

[1] Breland, J. Y.; Donalson, R.; Dinh, J. V.; and Maguen, S. (2018). Trauma exposure and disordered eating: A qualitative study. Women & Health, 58(2), 160–174. https://doi.org/10.1080/03630242.2017.1282398.

[2] Tagay, S.; Schlottbohm, E.; Reyes-Rodriguez, M. L.; Repic, N.; and Senf, W. (2014). Eating disorders, trauma, PTSD, and psychosocial resources. Eating Disorders, 22(1), 33–49. https://doi.org/10.1080/10640266.2014.857517.