by Carol Fredrek

 The link between eating disorders and trauma is well known. According to a study conducted by the National Institute of Mental Health, the prevalence of post traumatic stress disorder (PTSD) in eating disorder patients is about 24.3%.  And half of those suffering from an eating disorder also suffer from an anxiety disorder.

I first started working in the field of trauma when I did my graduate studies internship in a hospital based eating disorder program in 1989.  I found out very quickly that I could not treat eating disorders without having the knowledge of trauma.  Many of the eating disorder behaviors were rooted in early trauma.

PTSD is a Serious Anxiety Disorder

PTSD is a common risk factor for eating disorders. People with PTSD are three times more likely to develop an eating disorder than someone without an eating disorder.  More than 35% of women with bulimia have suffered sexual abuse, and 30% of individuals with an eating disorder have been sexually abused.

5 Things That Will Help You In Your Journey To Recovery

1. PTSD Is a Co-occurring Disorder

  • PTSD and eating disorders often co-occur.
  • It is essential that you address both disorders simultaneously to resolve the underlying issues.
  • Your eating disorder may have developed as a way of coping with the overwhelming feelings from the traumatic experience.  
  • Or your eating disorder may have become a way to re-establish control, as trauma often results in a feeling of being out of control.

2. Eating Disorder Behavior As A Coping Mechanism

  • A way to feel comfort or relief from painful feelings.
  • A way of coping with the discomforting emotions associated with the traumatic experience.
  • An attempt to control overwhelming feelings of low self-esteem, lack of control, loneliness, depression, and anxiety. The same symptoms that are experienced from trauma and abuse.
  • Your eating behaviors can escalate into an eating disorder quickly, if continued.
  • If you are trying to fix your body, you may be trying to fix your past. 
  • Your bingeing and purging may be connected to the trauma as a means of protection.
  • The binge-purge cycle may represent the need to cleanse yourself of the traumatic experience.
  • Or your binge-purge cycle may be a re-enactment of the trauma itself.

Your eating behaviors can escalate into an eating disorder quickly, if continued.

3. Body Shame

 Body shame sparks a large amount of eating disorders related to child sexual abuse. Body shame might trigger habits geared toward destroying the body because the victim is so ashamed. This may result in starvation, purging, or binge eating.

Ashamed woman, sitting on the floor

4. How Do I Know If I Have PTSD?

There are specific criteria in the DSM-V, a diagnostic manual that is used to help diagnose a variety of psychological conditions.  The first five criteria for PTSD include the following.

Criterion A – You have directly experienced a trauma or have witnessed trauma.  The following are only examples, there are many other events that cause a trauma response.

  • Childhood Sexual Abuse
  • Domestic Violence
  • Rape
  • Loss
  • Natural Disaster
  • Emotional Abuse
  • Car Accident

Criterion B – You persistently re-experience the trauma in the following ways.

  • intrusive thoughts
  • nightmares
  • flashbacks
  • physical reactivity
  • triggers of event

Criterion C – You avoid any stimuli related to the trauma.

  • Avoiding certain people, places, or things that lead to disturbing thoughts or memories of the event

Criterion D – You have negative thoughts or feelings that began or worsened after the trauma

  • Inability to recall features of the trauma
  • Overly negative thoughts and assumptions about oneself or the world
  • Decreased interest in activities
  • Feeling isolated

Criterion E – You experience hyper-arousal and reactivity related to the trauma, that began or worsened after the trauma

  • Irritability or aggression
  • Risky or destructive behavior
  • Hyper-vigilance
  • Difficulty sleeping
  • Difficulty concentrating

5. Signs That I Might Have An Eating Disorder

  • Loss of appetite – calorie restricting
  • Recurring binging or overeating to numb or escape painful feelings
  • Extreme weight fluctuations (weight gain or loss)
  • Avoidance of activities involving food
  • Engaging in purging: vomiting, laxative use, or over-exercising
  • Preoccupation with food, body, and weight

Traumatic experiences in one’s life will likely cause high levels of stress and anxiety, which can lead to destructive ways of coping.

It is imperative that with an eating disorder that you establish healthy coping mechanisms.

Full Recovery Is Possible