The Relationship Between Eating Disorders and Trichotillomania
Trichotillomania is a psychological disorder characterized by recurrent, compulsive urges to pull out one’s hair, both from the scalp and other parts of the body. Trichotillomania shares many clinical signs and symptoms with eating disorders. Both disorders may develop as a mechanism of inadvertently coping with internal conflict or underlying issues. The success rate of overcoming an eating disorder and trichotillomania is greatly increased when both disorders are treated together.
by: Amanda Nussbaum
Although eating disorders involve dangerous behaviors and thoughts surrounding food, exercise, diet, and body image, the root of these disorders stems from other components. For example, eating disorders are the result of a complex combination of genetic, sociocultural, and environmental risk factors. Other factors that may not cause but often contribute to the development of eating disorders include the influence of social media, perfectionism, the pressure to do well in school and activities, and relationships. Many people suffering from an eating disorder also suffer from other mental health disorders that often cooccur with eating disorders. Eating disorders share similar risk factors and behavioral characteristics with body-focused repetitive disorders (BFRBs). BFRBs are anxiety and obsessive-compulsive disorders that affect 1 in 20 people. These disorders cause, among other things, urges to pick or tug at certain body parts. Although there are a variety of disorders categorized as a BFRB, one such disorder is trichotillomania.
Trichotillomania is a type of BFRB characterized by an impulse or urge to pull or pick at one’s hair. Similar to eating disorders, trichotillomania typically develops during adolescence, but symptoms can also appear at any age. While it is most common for people with trichotillomania to pull hair from their head, it is also typical for individuals with the disorder to pick at their eyebrows, eyelashes, pubic areas, or any other part of the body with hair.
According to the American Journal of Psychiatry, trichotillomania often goes undiagnosed even though 0.5-2% of the population have the disorder. Although it is equally as common in both genders at a young age, trichotillomania is more prevalent in adult females. Those with trichotillomania often feel relieved when they pull at the hair because the behaviors associated with the disorder are used to self-soothe. Some people concentrate on specific hairs, while others do not realize when they are picking. For example, some may pick at their hair when they are bored, watching television, at school, at work, or in bed.
While there are many different warning signs of eating disorders, individuals with trichotillomania also may exhibit a variety of symptoms. Some signs include not being able to stop picking at their hair despite previous attempts to stop, having patchy hair, stubble, or bald spots, missing eyebrows or eyelashes, playing with or feeling the pulled hair, or chewing and consuming hair (a condition known as trichophagia). Just as eating disorders may cause someone to under- or over-eat as a way to cope with their feelings, those with trichotillomania often turn to hair pulling as a way to do the same. Many try to hide their eating disorder by wearing baggy clothing or multiple layers. Similarly, those with trichotillomania may try to conceal hair loss with makeup, wigs, or hats. Eating disorders and trichotillomania often result in poor self-esteem and body image, which can lead to avoidance of social situations and feelings of shame. Although there has been little research done on eating disorders and trichotillomania comorbidly, one study concluded that 20% of those with trichotillomania had both conditions.
Eating disorders and trichotillomania are associated with internal conflicts, obstructive thoughts, and compulsive behaviors, therefore it is important for these disorders to be treated concurrently. The behaviors associated with both disorders are used to manage stress and negative emotions. If they are not treated together, one disorder may improve while the other worsens. Individuals with eating disorders often work with a nutritionist or dietitian along with a specialized treatment team, while those who also have trichotillomania should meet with a BFRB therapist or psychiatrist to understand why they engage in hair-pulling behaviors and learn ways to control their urges. The goal is to work toward reversing habits in therapy to identify possible triggers and learn to replace the disordered behaviors with appropriate coping mechanisms.
At BALANCE eating disorder treatment center™, we treat the spectrum of eating disorders, including Anorexia, Bulimia, Binge Eating Disorder, compulsive overeating, and other disordered eating behaviors and body image issues. Currently, we are offering a range of virtual programs and services which include full eating disorder programming, outpatient groups, nutrition counseling, and meal support. BALANCE offers clients four distinct levels of care to meet their specific treatment needs, including a day program, weeknight program, step-down groups, and individual nutrition services. Click the button below to learn more about our programs and services.
This post was written by BALANCE Blog Intern, Amanda Nussbaum.
Amanda is a recent graduate of Ramapo College, where she majored in Business Administration with a concentration in Marketing. She enjoys being creative, writing, and editing videos, and is passionate about health, wellness, and lifestyle. Throughout college, Amanda volunteered with the Girls on the Run organization, which helps young girls develop a positive self-esteem. She also mentored a young girl through Ramapo College’s chapter of Big Brother, Big Sister. Amanda’s involvement in these organizations helped her realize that she wants to work for a company that has an impact on others, while still being creative with marketing. In the future, Amanda hopes to work in the marketing or communications department of an organization that focuses on teenagers and young adults, and their health and self-confidence. She enjoys contributing to the BALANCE blog!