Trauma and Eating Disorders
It is well-known that eating disorders are highly co-morbid with other psychiatric conditions. Among them, post-traumatic stress disorder (PTSD) and experiencing trauma are significantly associated with the development of an eating disorder.
By: Ekin Kiyici
Although eating disorder behaviors may surround dysfunctional relationships with food and body image, the root cause for a portion of the ED population could have nothing to do with food. In several cases, those dysfunctional relationships may develop from unresolved and untreated trauma.
The Link Between Trauma and Eating Disorders
Eating disorders and trauma are highly correlated.¹ Research suggests one in four individuals with an eating disorder show symptoms of PTSD.² Additionally, a study with 2,400 individuals hospitalized for an eating disorder found that 97% of those individuals had a co-occurring condition. Of that 97%, 22% were diagnosed with post-traumatic stress disorder.³
Symptoms of psychological trauma include hyperarousal of emotions, severe anxiety, fear, feelings of sadness or numbness, shame, digestive symptoms, and much more. Examples of trauma include sexual assault, physical abuse, the sudden loss of a loved one, harassment, living through natural disasters and wars, being attacked, kidnapped, and several others.
PTSD may develop when trauma goes unresolved, persists, and worsens. Symptoms of PTSD may include but are not limited to reliving the traumatic event through flashbacks, nightmares, severe anxiety or emotional distress, physical reactions to triggers, uncontrollable and unwanted thoughts about the incident, and trying to avoid thinking about it by avoiding places, activities, or individuals.
Individuals often find comfort in their eating disorder and the control they may feel they have over it. Binge eating disorder and bulimia appear to help reduce hyperaroused emotions or anxiety associated with trauma. Those behaviors may help numb, avoid, and forget about traumatic experiences. Further, engaging in those behaviors becomes reinforcing and may develop into a maladaptive coping mechanism for self-protection.⁴ Those behaviors allow for a momentary escape from emotions associated with trauma. Therefore, treatment needs to help uncover emotions associated with both the trauma experienced and the eating disorder.
Treatment Options
Some eating disorder treatment facilities and specialists can concurrently treat both trauma and an eating disorder. Often, alleviating symptoms of one does not mean signs of the other will reduce as well. Research suggests unresolved trauma or PTSD can significantly contribute to the maintenance of eating disorder symptoms and behaviors.³,⁵ Therefore, it is vital to find an eating disorder treatment option that uses a trauma-informed, integrated approach for addressing all issues that present themselves.
Several forms of therapy have proven to be effective for both eating disorders and trauma. A few are dialectical behavioral therapy, exposure therapy, EMDR, art therapy, animal-assisted therapy, and more. There are several shared themes between eating disorders and trauma. Residential treatment or intensive outpatient programs are a great place to start overcoming intertwined issues.
In order to recover from trauma, a stable and safe environment is crucial, and it allows individuals to disconnect from any dangers. The elimination of external stressors or triggers grants individuals the space to build healthier coping mechanisms, relationships, and alleviate symptoms.
At BALANCE eating disorder treatment center™, our compassionate, highly skilled team of clinicians is trained in diagnosing and treating the spectrum of eating disorders, including anorexia, bulimia, binge eating disorder, compulsive overeating, and other disordered eating behaviors and body image issues. In addition to our full-time Day Treatment Program and Weeknight Intensive Outpatient Program, we offer high-quality programming, nutrition counseling with a licensed dietitian, meal support, and various other groups and resources to help those seeking help for food concerns.
Our admissions team would be happy to answer any questions you may have about our programs and services. Book a free consultation call with our admissions team below, or read more about our philosophy here.
This post was written by BALANCE Intake Coordinator, Ekin Kiyici (she/her).
Ekin Kiyici is an Admissions Assistant at BALANCE eating disorder treatment center. She graduated in 2020 from the University of California, Los Angeles, with a Bachelor of Science in Psychobiology. During her undergraduate career, she coordinated four studies as a research assistant for both the Anxiety and Depression Research Center and the Mind-Body lab. She is also currently a writer for a mental health and wellness platform, The Human Condition. Ekin is very passionate and dedicated to aiding in the treatment of eating disorders and wants to better understand the variables that span across eating, anxiety, and mood disorders. She plans to pursue a doctoral program in Clinical Psychology with the hopes of providing accessible treatment to eating disorder and anxiety populations as a clinical psychologist.
References
Mitchell, K. S., Mazzeo, S. E., Schlesinger, M. R., Brewerton, T. D., & Smith, B. N. (2012). Comorbidity of partial and subthreshold ptsd among men and women with eating disorders in the national comorbidity survey-replication study. The International journal of eating disorders, 45(3), 307–315. https://doi.org/10.1002/eat.20965
Tagay, S., Schlottbohm, E., Reyes-Rodriguez, M. L., Repic, N., & Senf, W. (2014). Eating disorders, trauma, PTSD, and psychosocial resources. Eating disorders, 22(1), 33–49. https://doi.org/10.1080/10640266.2014.857517
Statistics & Research on Eating Disorders. National Eating Disorders Association. (2020, May 8). https://www.nationaleatingdisorders.org/statistics-research-eating-disorders.
Brewerton T. D. (2007). Eating disorders, trauma, and comorbidity: focus on PTSD. Eating disorders, 15(4), 285–304. https://doi.org/10.1080/10640260701454311
Brewerton, T. D., & Dennis, A. B. (2015). Perpetuating factors in severe and enduring anorexia nervosa. In S. Touyz, P. Hay, D. Le Grange, & J. H. Lacey (Eds.), Managing Severe and Enduring Anorexia Nervosa: A Clinician's Handbook. New York: Routledge.