Exploring the Intersection of Eating Disorders and Trauma

According to “Eating Disorder Statistics” from the National Association of Anorexia Nervosa and Associated Disorders (ANAD), approximately 28.8 million (9%) people in the U.S. experience an eating disorder in their lifetime. Despite the prevalence of eating disorders, stigma and poor mental health literacy (MHL) can delay treatment entry and engagement. Eating disorders do not develop independently or stem from a personal choice. Rather, underlying factors like untreated trauma can increase your risk of developing an eating disorder. Therefore, understanding the relationship between eating disorders and trauma can give you tools for long-term recovery.

At The Guest House, we strive to help you uncover and process the roots of your trauma. We know unaddressed trauma can leave you feeling stuck and overwhelmed by your distress. Further, overwhelming distress can contribute to self-defeating and self-destructive thinking and behavior patterns. When you are overwhelmed by your trauma, you are more likely to misuse substances and develop or exacerbate other disorders like eating disorders. Thus, eating disorders and trauma can have a significant impact on your well-being. Fortunately, we are committed to treating eating disorders and trauma with holistic healing. Through holistic healing, you can uncover the intersecting relationship between eating disorders and trauma to recover.

Yet, you may still question how eating disorders and trauma work together. How can trauma impact your relationship with food? Due to stigma and MHL, your understanding of eating disorders can be limited or misrepresented. Thus, increasing your knowledge of eating disorders and trauma can support understanding. There are several types of eating disorders, and each can uniquely affect your thoughts, emotions, and behavior. Meanwhile, addressing these different types of eating disorders can help you better understand the intersection between eating disorders and trauma.

Understanding Eating Disorders

There are several different – yet interrelated – types of eating disorders. Some of the most well-known eating disorders include anorexia nervosa, binge eating, and bulimia nervosa. Regardless of the type of eating disorder that a person may have, any challenges related to food and weight can have a profound impact on their physical and psychological health. Moreover, together, eating disorders and trauma can impede your ability to make healthy choices for your mind and body. Listed below are some disorders that can highlight the connection between eating disorders and trauma:

Anorexia Nervosa

This eating disorder can be broken down into two subtypes: restrictive subtype and binge-purge subtype. In the restrictive subtype, you severely limit the amount and the types of foods you consume. On the other hand, in the binge-purge subtype, you may place severe restrictions on the amount and types of foods you consume. Anorexia nervosa can also include binge eating and purging episodes. During these episodes, you consume large amounts of food during a short period along with compensatory behavior, such as vomiting or the use of laxatives, to purge the consumed food. Some additional characteristics of anorexia nervosa include:

• Distorted body image
• Intense fear of gaining weight even when you are underweight
• Overuse of weight loss methods
  • Excessive exercising and dieting
• Excessively weighing yourself

Binge Eating Disorder

With binge eating disorder, you experience reoccurring episodes in which you consume unusually large amounts of food in a shorter period than is typically expected. Additionally, during a binge-eating episode, you feel like you have lost control over your eating. You may eat quickly and to the point of discomfort as well as experience feelings of guilt, shame, and distress following a binge eating episode.

Bulimia Nervosa

With bulimia nervosa, you have recurrent episodes of overeating unusually large amounts of food, characterized by a loss of control over your eating. Oftentimes, these episodes of binge eating are followed by compensatory behavior in an attempt to prevent weight gain, accompanied by feelings of guilt and fear following a binging and purging episode. Compensatory behavior common for this type of eating disorder includes:

• Vomiting
• The use of laxatives or diuretics
• Excessive exercise
• Fasting

Disordered Eating

With disordered eating, you engage in unhealthy eating patterns that can lead to poor health outcomes like poor nutrition and co-occurring mental health disorders like depression. Additionally, disordered eating behaviors can involve:

• Losing weight and regaining it in cycles known as yo-yo dieting
• Excessive calorie counting
• Building strict rules around what you eat and how much you exercise
• Feelings of anxiety around foods you deem unhealthy or bad
• Hyper-focusing on what you eat and how much you eat
• Feelings of guilt and shame about food, weight, and your body image
• Engaging in excessive exercise and fasting to make up for overeating

Rumination Disorder

With rumination disorder, you regularly regurgitate your undigested or particularly digested food from your stomach to re-chew, re-swallow, or spit out. Further:

• The regurgitated food is described as normal-tasting
• Regurgitation appears to be effortless
• You do not appear to be distressed throughout the process

Avoidant Restrictive FoodIntake Disorder (ARFID)

Previously known as selective eating disorder, ARFID is the restricting of the amount and types of food you consume. Unlike the restriction found in anorexia nervosa, ARFID is not accompanied by distorted body image or fear of weight gain. Rather, you do not consume enough calories to maintain basic bodily functions. Additional characteristics of ARFID include:

• The range of foods you eat becomes more and more restrictive over time
• Significant weight loss
• A loss of appetite and or interest in food
• Frequent digestive issues
• Taking longer to finish a meal

Additional Types of Eating Disorders

Other types of eating disorders include:

• Other specified feeding and eating disorders (OSFED): A serious and life-threatening eating disorder previously known as an eating disorder not otherwise specified (EDNOS).
  • OSFED is often used as a catch-all classification for individuals who do not meet all the criteria for anorexia nervosa or bulimia nervosa
• Unspecified feeding or eating disorder (UFED): You experience feeding and eating disorder symptoms that do not meet the  criteria for known feeding and eating disorders
  • Your feeding and eating symptoms cause significant distress and impairment in important areas of function like social and occupational functioning

Looking at the many different types of eating disorders highlights how important body image and thus your mental health is to these challenges. Thus, the challenges with body image can hint at the intersecting nature of eating disorders and trauma. However, you may question how or what kinds of trauma can foster negative thoughts about your body and eating. Although there is no one specific cause for an eating disorder, understanding some of the causes can be beneficial. Learning more about the potential causes of each disorder can showcase the relationship between eating disorders and trauma.

Listed below are some of the causes of eating disorders that can stem from trauma:

Anorexia Nervosa

• Developing an anxiety disorder in childhood
• Negative self-image
• Eating challenges in infancy and early childhood
• Perfectionism
• Specific cultural perceptions of beauty and health

Binge Eating Disorder

• Can develop during or following entrance into dieting culture
• Co-occurrence with other eating disorders like bulimia nervosa

Bulimia Nervosa

• Genetic risk factors
• Trauma
• Other psychological challenges
• Family’s beliefs and behaviors toward food, eating, and weight
• Specific cultural and societal perceptions of food, weight, and image

Disordered Eating

• Difficulty regulating your response to stress
• Co-occurring mental health disorders
  • Depression
  • Interrelated eating disorders and trauma-related conditions
    • Post-traumatic stress disorder (PTSD)
    • Military sexual trauma (MST)
    • Anxiety disorders

Rumination Disorder

• Often triggered by an event
  • Infection
  • Life stress
  • Emotional neglect
  • Other mental health challenges
    • Attention deficit-hyperactivity disorder (ADHD)
    • Depression
    • Interrelated eating disorders and trauma-related disorders
      • Anxiety
      • PTSD
      • Obsessive-compulsive disorder (OCD)
  • Rectal evacuation disorder
  • Developmental delays

ARFID

• Interrelated eating disorders and trauma
• Other trauma-related disorders
  • Anxiety
• Excessive fears from triggered events
  • Choking
• Genetic changes
• Social, cultural, and environmental factors

OSFED

• Genetic factors
• Psychological challenges
  • Co-occurring eating disorders and trauma-related conditions
    • Anxiety disorders
    • PTSD
  • Other co-occurring mental health disorders and conditions
    • Depression
    • Substance use disorder (SUD)
    • Self-injurious behaviors
• Sociocultural factors

UFED

• Genetics
• Sociocultural influence
• Co-occurring mental health disorders
  • Depression
  • Anxiety disorders
  • Suicidal ideation
• Interrelated eating disorders and trauma-related conditions
  • PTSD
  • Acute stress disorder (ASD)

Looking at all the potential causes of various eating disorders showcases the variety of ways eating challenges can develop. Although there is not a clear direct cause of eating disorders, identifying underlying causes can address the significance of informative experiences. Your experiences across your life can play an important role in the development of one or more eating disorders. In particular, eating disorders and trauma from different stressful experiences often coincide with each other. Therefore, looking more closely at the risk factors for eating disorders can give insight into the relationship between eating disorders and trauma.

The Relationship Between Eating Disorders and Trauma

According to the Journal of Eating Disorders, eating disorders are psychiatric conditions that can lead to psychological and physical impairments. Specifically, several main risk factors contribute to the development of an eating disorder. Listed below are some of the main risk factor categories that can contribute to eating disorders:

• Genetics: You are more likely to develop an eating disorder if a parent has a history of one or more eating disorders
  • There is an increased risk for anorexia, bulimia, and binge eating if a relative has one of the three disorders
• Gastrointestinal microbiota and autoimmune reactions: Dysregulation of the gut microbiome contributes to developing eating disorders
  • Endocrines in the gastrointestinal (GI) tract communicate with the brain to regulate appetite and satiety
    • Dysregulation disrupts typical feelings of fullness
  • Gut microbiota impact autoimmune responses
    • There is a greater risk for eating disorders when autoimmune and autoinflammatory diseases are present
• Exposure to adverse childhood experiences (ACEs) in childhood and early adolescence: Eating disorders and trauma share a direct link to exposure to traumatic experiences in your early life
  • Parental mental health conditions
  • Negative parent-child relationship
  • Maladaptive parental eating behaviors
  • Negative family communication about food and weight
  • Significant family disruption like separation
  • Childhood abuse and neglect
    • Sexual abuse,  verbal abuse, and physical neglect
• Gender: Girls and women are more likely to develop an eating disorder due to sex, gender norms, and societal expectations
  • Bodily changes during puberty
  • Gender roles
  • Societal and cultural body ideals for females
  • Co-occurring mental health disorders
    • Depression
    • Anxiety
• Personality traits and co-occurring mental health disorders: Challenges with anxiety, perfectionism, impulsivity, obsessive behaviors, compulsive behaviors, and other co-occurring disorders
  • ADHD
  • PTSD

In other words, there are a range of factors that can make you vulnerable to developing an eating disorder. Specifically, looking at risk factors like ACEs highlights the reality that eating disorders and trauma are deeply interconnected. Moreover, the experiences you have in your early life can have a profound impact throughout your lifespan.

Prevalence of Childhood Trauma in Eating Disorders

ACEs are often associated with unimaginable traumas like sexual abuse. However, the scope of ACEs can include a significant variety of traumatic experiences that you may not recognize as trauma. As noted in Children., child traumatic experiences can include emotional abuse, physical and emotional neglect, bullying, and witnessing intimate partner violence (IPV).

Although traumatic childhood experiences have a clear impact on your life, you may question its relationship to eating disorders. You may wonder if the trauma you experienced is not directly related to food and weight, how are eating disorders and trauma related? In particular, eating disorders and trauma share similar negative self-perceptions.

The experience of trauma, especially interpersonal trauma can lead to profound feelings of self-blame and guilt about the trauma. Further, experiencing trauma in childhood when you are still developing can make it more difficult to understand it was not a failure on your part. Some of the mediating factors between eating disorders and trauma include:

• Dissociation: A psychological defense mechanism used to escape distress from unaddressed ACEs
• Emotional dysregulation: You have difficulty controlling your emotions and how you act on your feelings
  • Regulation challenges often stem from traumatic and stressful experiences in early childhood
• Self-criticism: A tendency to engage in negative self-evaluation about yourself
  • Often leads to feelings of worthiness and failure, low self-esteem, and guilt
  • Negative beliefs about yourself including your body often stem from and or are exacerbated by childhood trauma
• Body dissatisfaction: You have persistent negative thoughts and feelings about your body
  • Often stems from ACEs that warp the way you see and think about your body
    • Negative comments about your body from parents and or peers
    • Exposure to unrealistic body types

Looking at the mediating role between eating disorders and trauma showcases the influence of psychological distress on thoughts and behavior. Further, the mediating roles of eating disorders and trauma speak to the importance of negative self-evaluation in worsening body image.

Impact of Eating Disorders and Trauma on Body Image

The challenges of poor body image in eating disorders and trauma can be born out of a desire for self-punishment or disgust following a trauma. When the trauma you experienced as a child is related to the body like sexual abuse, you are more likely to view your body negatively. Your body becomes a reminder of your trauma and its overwhelming distress. As noted in “Impact of Trauma in Childhood and Adulthood on Eating-Disorder Symptoms” by Ariana G. Vidaña et al., eating disorder symptoms are maladaptive coping strategies.

Through eating disorders, you attempt to emotionally numb or avoid the symptoms of your trauma. Childhood trauma exposes you to negative coping styles like self-criticism. Thus, you engage in negative coping strategies through eating disorders to escape the overwhelming distress of unresolved trauma. As a result of the relationships between the body and negative self-perception, you can support healing eating disorders and trauma with body-centered therapies like somatic experiencing (SE).

The Bodily Connection: Exploring Therapeutic Interventions at The Guest House

Mindfulness-based interventions and body-centered therapies like SE can support mind, body, and spirit healing. With mindfulness, you can learn skills and techniques to support nonjudgmental acceptance of your inner self. The acceptance of your internal experiences includes your thoughts, feelings, and somatic sensations, which speaks to healing as a whole-person process. Moreover, mindfulness helps you dismantle unhealthy thinking and behaviors by cultivating:

• Greater self-acceptance
• Increased self-awareness and self-understanding
• More compassion for yourself
• Greater capacity for self-forgiveness
• Improved cognitive flexibility and emotional regulation
• Increased ability to engage in adaptive coping

Looking at the adaptive thoughts, feelings, and behaviors that can come with mindful interventions highlights eating disorders and trauma mind-body connection. Thus, therapeutic modalities like SE in particular can help address the physical and psychological aspects of eating disorders and trauma. Through SE, you learn how to modify your reaction to your trauma-related stress response.

In particular, SE focuses on helping you learn to tolerate and eventually accept the inner somatic sensations born out of your trauma. Further, the increased toleration and acceptance of inner physical sensations help you reduce distress and maladaptive coping strategies. At The Guest House, we are committed to providing treatment centered on holistic healing. Through a wide variety of holistic therapies and modalities, you can find the tools you need to heal in mind, body, and spirit.

Many eating disorders are born from traumatic experiences. More specifically, eating disorders and trauma often stem from adverse childhood experiences (ACEs). Your ACEs can include experiences like unrealistic beauty standards, sexual abuse, and emotional neglect. Experiences with early trauma can disrupt the way you perceive yourself in mind and body. With negative self-evaluation, you engage in negative coping strategies like the symptoms of eating disorders to cope with unaddressed traumatic distress. However, with access to mindful and body-centered therapies, you can support healing in mind, body, and spirit. At The Guest House, we are committed to providing a wide range of holistic therapies and modalities to address your specific recovery needs. To learn more call (855) 483-7800 today.