The Link Between Eating Disorders and Trauma
Eating Disorders are complex psychological, nutritional, and medical disorders that often occur with other mental health disorders. Often in eating disorder treatment, the focus is on symptom reduction. While that is important in eating disorder recovery, underlying or co-occurring mental health disorders often go unaddressed.
The overlap between trauma and eating disorders is significant. Multiple reviews and research studies have concluded that 18-25% of individuals with eating disorders also experience trauma (Ferrell, 2022).
This blog post explores how unresolved trauma can lead to an eating disorder, what effective treatment looks like, and why recovery is possible.
How Eating Disorders Can Develop as a Trauma Response
When someone experiences trauma, there is often a feeling of loss of control. When this happens, the nervous system looks for other ways to feel safe and in control—often through food and body image.
For example, let’s say someone gets in a car accident and has to use crutches to regain the strength and mobility to walk on their own. They perceive these restrictions as a loss of control, as they now have to rely on others to assist them with tasks they used to do on their own, such as driving and walking down stairs. They may also have gained some weight since the accident, and their movement is restricted. This loss of control may be too overwhelming for their nervous system to handle, so they (usually unconsciously) develop another way to regain control, restricting their food intake and cutting out certain food groups they deem unhealthy. They end up fixating on wanting to lose weight, coupled with the restrictive eating, and are diagnosed with an eating disorder.
Treatment for Eating Disorders and Trauma
The key to healing from trauma and an eating disorder is with a dual specialist. In other words, you’d work with a therapist trained in both eating disorder treatment and trauma therapy. This ensures that the eating disorder symptoms are treated while the underlying trauma or other mental health conditions are addressed.
The old way of approaching treatment for someone with co-occurring disorders was to treat the eating disorder first and then the trauma. More recently, there has been more success and encouragement to treat the eating disorder and the trauma at the same time.
For the person in our example, this means finding a therapist who specializes in both eating disorders and trauma. The therapist would take the first few sessions to establish rapport and gather information from the client, such as current symptoms, their impact on daily living, and mental health history. Then the therapist and client work together to come up with a treatment plan that addresses both the eating disorder and the trauma.
For co-occurring eating disorders and trauma, I recommend a therapist trained in DBT (dialectical behavior therapy), EMDR therapy (Eye Movement Desensitization and Reprocessing), Ego State Therapy (also known as Parts Work Therapy), Relational Therapy, or DBR (Deep Brain Reorienting). This is not an exhaustive list of methods – just a place to get you started when looking for a therapist.
In addition to a therapist, treatment for an eating disorder usually includes other professionals, such as a registered eating disorder dietitian, a psychiatrist or medication provider, and a physician.
Hope and Healing
I won’t sugarcoat it – recovery from an eating disorder and trauma can be exhausting and emotionally taxing. Many people are fearful about starting therapy to address these issues. That said, it can provide you with insight into how the eating disorder developed, how trauma contributed to the eating disorder, and how to prevent future relapses from occurring. Therapy can also be effective in reducing the symptoms of the eating disorder and trauma.
A good trauma and eating disorder therapist will go at the pace of your nervous system (barring any medical or safety concerns). If treatment feels too fast, there are ways to adjust interventions to make it feel more comfortable.
Getting help can be scary. It can also be the bravest thing you do for yourself. Help is available.
Finding the right therapist—especially one who specializes in both eating disorders and trauma—can feel overwhelming. Our Resource Specialists are here to help. We’ll listen to your situation, answer your questions, and connect you with treatment providers who are the right fit for your needs and recovery journey.
About the Author: Megan Samuels, MSW, LCSW-C, is an eating disorder and trauma therapist at The Eating Disorder Center, practicing in Maryland and Virginia. She offers therapy for teens and adults, focusing on the intersection of trauma (including complex trauma and dissociative disorders) and eating disorders. She is passionate about providing compassionate and supportive care for folks struggling with an eating disorder and/or trauma.
Learn more at https://www.theeatingdisordercenter.com/
References:
Ferrell, E. L., Russin, S. E., & Flint, D. D. (2022). Prevalence estimates of comorbid eating disorders and posttraumatic stress disorder: A quantitative synthesis. Journal of Aggression, Maltreatment & Trauma, 31(2), 264-282.
Photo by Kian Mousazadeh: https://www.pexels.com/photo/woman-with-hands-on-face-19193208/
The opinions and views expressed in any guest blog post do not necessarily reflect those of www.rtor.org or its sponsor, Laurel House, Inc. The author and www.rtor.org have no affiliations with any products or services mentioned in the article or linked to therein. Guest Authors may have affiliations to products mentioned or linked to in their author bios.
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